The relation between plasma levels of nesfatin-1 and different grades of diabetic kidney disease in patients with type 2 diabetes

Abstract

Diabetic kidney disease (DKD) is the leading cause of renal failure. Diabetic patients with microalbuminuria typically progress to proteinuria and overt diabetic nephropathy. Nesfatin-1 is an anoretic polypeptide with potent metabolic regulatory effects and its circulating levels are shown to be elevated in type 2 diabetes mellitus (T2 DM). Nesfatin-1 may be involved in the pathogenesis of DKD through inflammatory mechanisms. The aim of the work was to study the relation between plasma nesfatin-1 levels and different grades of DKD in patients with T2 DM. This study was conducted on 120 patients with T2 DM and 20 controls selected from the inpatient department and outpatient clinics of the Internal Medicine Department in Menoufia University Hospital. The selected individuals were grouped into four groups: group1 included 20 healthy individuals, group 2 included 40 patients with T2DM with normoalbuminuria, group 3 included 40 patients with T2 DM with microalbuminuria, and group 4 included 40 patients with T2 DM with macroalbuminuria. Members of the study were subjected to thorough history with special emphasis on age, sex, and duration of the DM. Investigations included fasting blood glucose, glycosylated hemoglobin, complete urine analysis, serum creatinine, urine albumin–creatinine ratio, estimated glomerular filtration rate, and plasma nesfatin-1. Plasma nesfatin-1 was significantly higher in group 4 compared with other groups, in group 3 compared with groups 1 and 2, and in group 2 compared with group 1. There was a positive significant correlation between plasma nesfatin-1 and serum creatinine, urine albumin–creatinine ratio, and glycosylated hemoglobin and negative significant correlation between plasma nesfatin-1 and estimated glomerular filtration rate in the studied diabetic patients. There was no correlation between plasma nesfatin-1 and BMI and duration of diabetes in the diabetic patients. From this study, we can conclude that plasma nesfatin-1 is significantly higher in patients with DKD, and there is a positive correlation between plasma nefatin-1 level and the grades of DKD. So, plasma nesfatin-1 may be considered for prediction of developing DKD in a previously unaffected patients with DM.