Role of cystatin C and beta-2microglobulin in the diagnosis of type 2 diabetic nephropathy

Abstract

Nephropathy is one of the most frequent icrovascular complications of diabetes. It generates the most reserved prognosis since it increases the risk of end-stage renal failure. Despite microalbuminuria remains the gold test for the early detection of Diabetic Nephropathy (DN), the dosage of this parameter is insufficient to predict DN risks due to certain limitations. Therefore, there is a paradigm shift towards new biomarkers that may predict the risk of DN early and prevent the onset of end-stage renal disease. This study aims to compare the variation patterns of cystatin C (cys C) and beta-2 microglobulin (β2-M) with estimated Glomerular Filtration Rate (eGFR) for the early detection of DN in patients with type 2 diabetes (T2D), to assess the Albumin to Creatinine Ratio (ACR) and to search for risk factors for DN. A descriptive cross-sectional study was conducted on 368 diabetic patients and 90 no diabetic subjects in the hospital. The statistical analysis was performed using SPSS 22 software. The prevalence of nephropathy was 41.29% in a predominantly women cohort with a mean age of 59 years. Correlation analyses and diagnostic performance evaluation using Receiver Operating Characteristic (ROC) curves, referencing a creatinine-based on eGFR threshold of <60 mL/min/1.73 m², demonstrated that cys C and ß2-M biomarkers exhibit superior sensitivity and specificity compared to the ACR for detecting impaired renal function. The results of this study demonstrated that serum cys C and ß2-M could be reported as effective early markers of diabetic nephropathy prediction.