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ORIGINAL ARTICLE
Year : 2018  |  Volume : 46  |  Issue : 2  |  Page : 145-151

Prospective randomized study to evaluate urinary liver-type fatty acid binding protein in early detection of diabetic nephropathy in type 2 diabetic patients


1 Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
Eeem Awny
Clinical Pathology Department, Faculty of Medicine, Tanta University, El-Gharbia, El Mahalla El Koubra, Manshyet El Bakry, 8 Suez Street, 31159
Egypt
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DOI: 10.4103/tmj.tmj_54_17

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Background The early diagnosis of diabetic nephropathy (DN) is important to avoid the adverse outcomes of renal failure among diabetics. Although microalbuminuria has been recognized as a significant predictive marker for the early diagnosis of DN, some diabetics may develop DN without an apparent microalbuminuria. Therefore, sensitive and specific markers are required to detect DN in its early stages. Aim The aim of this work was to estimate the liver-type fatty acid binding protein (L-FABP) level in type 2 diabetes mellitus (T2DM) patients with DN and shed more light on its value and clinical significance. Materials and methods The present study was carried at the Clinical Pathology Department in Tanta University. It included 30 patients with T2DM, who attended the Outpatient Clinic of Internal Medicine Department, Tanta University Hospital, and fulfilled the criteria of the American Diabetes Association, 2015. The control group included 20 healthy individuals. The participants were subdivided into the following groups: group 1 included 10 T2DM patients with normoalbuminuria, eight women and two men. Their ages ranged from 55 to 75 years. Group 2 included 10 T2DM patients with microalbuminuria, five women and five men. Their ages ranged from 45 to 72 years. Group 3 included 10 T2DM patients with macroalbuminuria, four women and six men. Their ages ranged from 49 to 67 years. Group 4 included healthy individuals who served as a control group, nine women and 11 men. Their ages ranged from 43 to 75 years. Results The present study found that there was no significant difference between the three patient groups in disease duration, fasting, and postprandial blood glucose. There was a significant difference between the three patient groups in glycated hemoglobin, albumin in urine, glomerular filtration rate, and serum creatinine. There was a significant difference in L-FABP between the three patient groups and the control group. Conclusion Urinary L-FABP level was significantly increased in diabetic patients with DN compared with the control group. The levels of urinary L-FABP in each DN group were significantly increased according to the severity of DN. The high levels of L-FABP in urinary excretion were associated with deteriorating renal function in patients with T2DM. This association was frequently observed even in patients with normoalbuminuria


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