Biomarkers of renal dysfunction among Ghanaian patients with type 2 diabetes mellitus- a cross-sectional study

Type 2 diabetes mellitus (T2DM) is a heterogeneous collection of disorders characterized by reduced insulin sensitivity and increased glucose output. The abnormal vascular architecture observed within the first few years of diabetes onset suggests that complications such as nephropathy develop earlier in affected individuals than is generally known. Prompt determination of decline in renal function among diabetics is therefore very crucial. In the present study, we evaluated circulating levels of adiponectin, neutrophil gelatinase-associated lipocalin (NGAL), asymmetric dimethyl arginine (ADMA), and endothelial nitric oxide synthase traffic inducer (NOSTRIN) as novel biomarkers of renal dysfunction. One hundred and eight Ghanaian patients with T2DM were recruited for this study. Biochemical and immunoassays were employed in measuring the levels of the biomarkers for all participants. Metabolic syndrome indices including body mass index (BMI), serum glucose, and uric acid levels were not found to be associated with adiponectin concentrations. Fifteen participants had normal estimated glomerular filtration rate (eGFR), 79 had a mildly reduced eGFR, and 24 had moderately reduced eGFR representing 12.8, 66.9, and 20.3%, respectively. Proteinuria correlated significantly with decreasing eGFR. Serum levels of adiponectin, ADMA, and NOSTRIN (p=0.002; p=0.001; p=0.012, respectively) were, however, found to be independently associated with estimated glomerular filtration rate (eGFR) among the type 2 diabetics. We observed that elevated circulating levels of adiponectin, ADMA, and NOSTRIN could be important in characterizing early CKD stages among type 2 diabetics.