Evaluation of Neutrophil Gelatinase Associated Lipocalin, As A Biomarker of Renal Injury in Type 2 Diabetic Patients

Aim: To evaluate urinary excretion of Neutrophil Gelatinase Associated Lipocalin (NGAL) in type 2 diabetic patients with different stages of nephropathy. Methods: It was a cross-sectional study conducted at Shaikh Zayed Hospital, Lahore from Oct 2009 – Oct 2010.Ninety five subjects both males and females were divided into two groups. 75 type 2 diabetic patients (33 males and 42 females) were included in the Diabetic group and 20 healthy individuals were taken as Controls. Urinary Neutrophil Gelatinase Associated Lipocalin (uNGAL) was measured using NGAL Elisa method. Urinary Albumin and Creatinine were estimated on fully automated chemistry analyzer. Albumin Creatinine Ratio (ACR) was calculated as mg Albumin/g Creatinine. On the basis of ACR, diabetic patients were divided into 3 groups. Normoalbuminuric (<30mg Alb/g Cr), Microalbuminuric (30-300mg Alb/g Cr) and Macroalbuminuric (>300 mg Alb/g Cr). Results: The diabetic group showed highly increased levels of uNGAL (male diabetics mean=212.8±45.3 ng/ml, male controls mean=5.36±0.55 ng/ml and female diabetics mean=158.2±28.7 ng/ml, female controls mean=7.85±1.45 ng/ml).These levels increased in parallel with the severity of the renal disease. The ACR of female diabetics (279.62±106.17 mg Alb/g Cr) was significantly higher than the ACR of female controls (3.76±1.50 mg Alb/g Cr) and ACR of male diabetics (796.88±571.88 mg Alb/g Cr) was significantly higher than the ACR of male controls (1.44±0.78 mg Alb/g Cr). ACR of all the 3 diabetic groups showed a positive correlation with uNGAL except normoalbuminuric females. Conclusion: uNGAL relates closely with renal function markers. It may prove to be a sensitive and non-invasive biomarker for the early detection of diabetic nephropathy as well as renal injuries caused by reasons other than diabetes.