Urine Zinc-alpha-2-glycoprotein as a Potential Biomarker for Incipient Diabetic Nephropathy: A Pilot Study at a Tertiary Care Hospital

Abstract

Introduction: Urine albumin-creatinine ratio (UACR) continues to be used as an indicator for detecting diabetic nephropathy (DN); however, damage starts much before that. Currently, no biomarkers are there to indicate incipient damage. As a result, researchers are looking for new biomarkers that could be used to detect DN threats sooner and perhaps hinder the development of end-stage renal disease. The present study intended to know if urine Zinc-alpha-2-glycoprotein (ZAG) levels correlate with glomerular filtration rate (GFR) in the study participants of type 2 diabetes mellitus (T2DM). Materials and Methods: The study included 68 participants with a known history of T2DM. Serum urea and creatinine levels, fasting plasma glucose, serum cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total protein, glycated hemoglobin (HbA1c) and urine ZAG were estimated and UACR along with estimated GFR (eGFR) were calculated for all individuals. The characteristics of the study participants in the microalbuminuric and normoalbuminuric groups were compared. Results: The levels of urine ZAG in the microalbuminuric and normoalbuminuric groups were not observed to be substantially different. The relationship between urine ZAG and diabetes mellitus duration was found to be highly significant in normoalbuminuric patients. Urinary ZAG and correlation with categories of HbA1c % (good <7, 7–9 moderate, >9 poor) among normoalbuminuric individuals were not found to be significant. Conclusion: Despite previous research, we were unable to find a positive relationship between urinary ZAG concentrations and eGFR in this study. Prospective studies with greater sample sizes and follow-up are required to fully comprehend the possible use of ZAG as a biomarker in diabetic nephropathy.