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Article Type

Original Study

Abstract

Aim The aim of this study was to assess the levels of urinary type IV collagen, alpha-1 microglobulin, and transferrin as risk factors for early detection of nephropathy progression in diabetic patients. Patients and methods Four groups (25 patients each) participated in this study. Group I: controls, group II: type 2 diabetes mellitus (T2DM) with normoalbuminuria [albumin creatinine ratio (ACR)<30 mg/g], group III: T2DM with microalbuminuria, and group IV: T2DM with macroalbuminuria (ACR≥300 mg/g). Urinary type IV collagen, alpha-1 microglobulin, and transferrin levels were measured using enzyme-linked immunosorbent assay. The levels of glucose, glycosylated hemoglobin, lipids, urea, creatinine, and microalbumin were also measured. Results Significant elevation of glucose and glycosylated hemoglobin, total cholesterol, triglycerides as well as low-density lipoprotein cholesterol, and a significant reduction of high-density lipoprotein cholesterol were reported in diabetic nephropathy as compared with the control group and normoalbuminuric group (P<0.05). The dramatic significant increase in urinary type IV collagen, alpha-1 microglobulin, and transferrin levels were observed in diabetic patients with microalbuminuria and macroalbuminuria compared with those in the normoalbuminuric group (P<0.05). Type IV collagen, alpha-1 microglobulin, and transferrin were found to correlate positively and significantly with ACR in diabetic groups, and also type IV collagen and alpha-1 microglobulin were found to correlate positively and significantly with microalbumin, urea and creatinine in diabetic nephropathy groups. Conclusions Urinary type IV collagen, alpha-1 microglobulin, and transferrin levels are strongly associated with the prevalence of nephropathy in T2DM and could be promising useful biomarkers for predicting nephropathy progression, especially at early stages. Furthermore, they may serve as a tool to monitor the impact of prevention and intervention on renal damage.

Keywords

Alpha-1 microglobulin, transferrin, nephropathy, type 2 diabetes, type IV collagen

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