Plasma and Urinary Type IV Collagen Levels for Early Detection of Nephropathy in Type 2 Diabetes Mellitus Patients

Background: Diabetic nephropathy is a major complication with high morbidity and mortality, and leads to end stage renal disease (ESRD). Type IV collagen is the main component of the glomerular basement membrane (GBM) and the extracellular matrix. The thickening of the GBM is due to accumulation of type IV collagen and alterations in its structure and composition. Aim: The aim of this study was to evaluate the association of plasma and urine type IV collagen with albuminuria status and to determine the clinical implications of type IV collagen as a marker in the early stage of diabetic nephropathy. Materials and methods: A total of 150 type 2 diabetes mellitus patients with more than 5 year diabetic duration in the age group of 35 to 60 years were selected for this study and 50 age and sex matched healthy individuals were selected as control group. Type IV collagen (Plasma and urine), Insulin were analyzed by ELISA method and micro albumin was analyzed by turbilatex method. Routine investigations fasting plasma glucose, post prandial glucose, lipid profile parameters, serum urea and creatinine were analyzed by using Auto analyzer. Results: The plasma and urinary type IV collagen levels were significantly higher in the normoalbuminuric group with diabetes than in the control group, and increased with increasing severity of albuminuria among diabetics. Both plasma and urine type IV collagen levels showed positive correlation with albumin creatinine ratio (ACR) and regression analysis showed significant influence with ACR and also positive significant correlation of ACR with FPG, PPG, HbA1C, HOMA-IR, negative correlation with HDL cholesterol was observed. Conclusion: Plasma and urinary type IV collagen can be helpful in the prediction of the subsequent development of albuminuria in type 2 diabetic patients.