Neutrophil gelatinase-associated lipocalin: As a predictor of early diabetic nephropathy in Type 2 diabetes mellitus

A Kaul; MR Behera; MK Rai; P Mishra; DS Bhaduaria; S Yadav; V Agarwal; R Karoli; N Prasad; A Gupta; RK Sharma

doi:10.4103/ijn.IJN_96_17

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ORIGINAL ARTICLE

Year : 2018 | Volume : 28 | Issue : 1 | Page : 53-60

Neutrophil gelatinase-associated lipocalin: As a predictor of early diabetic nephropathy in Type 2 diabetes mellitus

A Kaul¹, MR Behera¹, MK Rai², P Mishra³, DS Bhaduaria³, S Yadav⁴, V Agarwal², R Karoli⁵, N Prasad¹, A Gupta¹, RK Sharma¹
¹ Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
² Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
³ Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
⁴ Department of Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
⁵ Department of Endocrinology, ERA Medical College, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. A Kaul
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijn.IJN_96_17

This study was carried out to look for diagnostic and prognostic role of neutrophil gelatinase-associated lipocalin (NGAL) in early diabetic nephropathy (DN) in type 2 diabetes individuals. NGAL was measured in both urinary and serum sample of 144 type 2 diabetes individuals stratified into three categories based on urinary albumin-creatinine ratio and 54 control populations with estimated glomerular filtration rate >60 mL/min/1.73 m² and serum creatinine <1.2 mg/dl. The serum NGAL (sNGAL), urine NGAL (uNGAL), and uNGAL/urine creatinine were significantly higher in diabetic individuals than in the control populations with significant difference in between the groups (P < 0.05). Difference of above values between control value and normoalbuminuria was also statistically significant (P < 0.05). Again, sNGAL and uNGAL correlate positively with albuminuria (P < 0.05). Tubular injury may precede glomerular injury in diabetic individuals, and NGAL can be used as a biomarker to diagnose DN even earlier to incipient nephropathy. Both sNGAL and uNGAL can predict albuminuria and be used as a noninvasive tool for diagnosis, staging, and progression of DN.

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