Correlation of Urinary Gamma Glutamyl Transferase to Creatinine Ratio with Albumin Creatinine Ratio in Patients with Type 2 Diabetes Mellitus

Abstract

Background: Diabetic Nephropathy is one of the most serious outcomes of Diabetes Mellitus worldwide. As tubular injury precedes albuminuria, tubular enzyme Gamma Glutamyl Transferase (GGT) may serve as a more sensitive diagnostic biomarker for diabetic nephropathy. Objective: To determine and correlate urinary Gamma Glutamyl Transferase to creatinine ratio with urinary albumin creatinine ratio (uACR) in Type 2 diabetics based on gender. Methods: A cross-sectional study was undertaken at Shaikh Zayed Hospital from March 2022 to April 2023. A total of 100 male and female participants were included in this study. The study participants included 75  type 2 diabetics and 25 controls. The diabetic group was subdivided into normoalbuminuric and microalbuminuric based on urinary albumin creatinine ratio.  All subjects' fasting blood glucose, urinary albumin, urinary creatinine, and urinary GGT levels were measured on the automated chemistry analyzer. The data was analyzed by SPSS version 24. “t-test” was used to compare the variables between different groups. The Pearson correlation test was used to establish the correlation between Gamma Glutamyl Transferase to creatinine ratio and uACR. Results: Urinary GGT (uGGT) levels were significantly higher in all type 2 diabetics as compared to controls (p <0.001). Both urinary albumin and uACR were raised in male diabetics (p<0.001) and female diabetics (p<0.005) as compared to controls, in male diabetics more increase was observed (p<0.001). A highly significant positive correlation was observed between uGGT:Creatinine ratio and uACR of all normoalbuminuric patients (‘r’ males=0.837 & females=0.919) and microalbuminuric patients (‘r’ males=0.600 & females=0.636) at p<0.001. Conclusion: Urinary Gamma Glutamyl Transferase to creatinine ratio is positively correlated with urinary albumin creatinine ratio and may serve as a more sensitive biomarker than urinary albumin creatinine ratio in diabetic patients with renal damage.