Volume: 43 Issue: 1
Year: 2023, Page: 299-302, Doi: https://doi.org/10.51248/.v43i01.2652
Introduction and Aim: The Diabetic Nephropathy (DN) is a result of impaired renal function in Type 2 diabetes. At the onset of diabetes, microvascular complication increases due to accumulation of free fatty acids (FFA) causing renal damage. A study was conducted to estimate the concentration of serum FFA causing severity of diabetic nephropathy.
Materials and Methods: 90 Type 2 diabetic subjects and 30 study controls (age group 35 to 65 years) were selected from the medicine OPD of S N Medical College and HSK Hospital, Bagalkot. Based on the presence of microalbuminuria, the 90 Type 2 diabetic patients were equally divided in to 3 groups, named as stage I to stage III. The serum FFA was estimated by ELISA method in these three groups and control subjects. The statistical analysis was done using SPSS software version 19 utilizing unpaired “t” test for quantitative data and Pearson’s correlation tests.
Results: The estimated serum FFA levels in stage I to III was found to be higher and highly significant as compared to control (p=0.001). We find the best cut off value of serum FFA was 4.75 mmol/L, causing severity of diabetic nephropathy. The area under the curve (AUC) is 0.92 with the specificity of 86%, sensitivity 89% and the diagnostic accuracy was found to be of 87%.
Conclusion: Serum free fatty acid levels were higher in diabetic nephropathy subjects, which could be used as diagnostic marker for the severity of renal damage with cut off value of 4.75 mmol/L
Keywords: Type 2 diabetes; diabetic nephropathy; serum free fatty acids; microalbuminuria.
1. Messallamy, El., Soliman, FA., Shalaby, SM., Abdel-Rahman, HA., Fetuin-A as a Marker of Insulin Resistance in Type 2 Diabetic Patients in Zagazig University. The Egyptian Journal of Hospital Medicine. 2020; 79(1):462-468.
2. Singh, V.P., Bali, A., Singh, N., Jaggi, A.S., Advanced glycation end products and diabetic complications. The Korean journal of physiology & pharmacology: official journal of the Korean Physiological Society and the Korean Society of Pharmacology 2014; 18(1):1.
3. Tsai, I.T., Wu, C.C., Hung, W.C., Lee, T.L., Hsuan, C.F., Wei, C.T., et al., FABP1 and FABP2 as markers of diabetic nephropathy. International journal of medical sciences 2020;17(15):2338.
4. Muttur, D.A. Analyzing Anthropometry and Metabolic Variables Associated with Microalbumin and C-Reactive Protein as Markers of Early Glomerular Dysfunction among Mauritian Patients Suffering from Type II Diabetes. The Internet Journal of Laboratory Medicine 2010; 4:219-226.
5. Yassin, M.M., Altibi, H. I., Shanti, A. F. Clinical and Biochemical Features of Type 2 Diabetic Patients in Gaza Governorate, Gaza Strip. West African Journal of Medicine 2010; 30(1): 51-56.
6. Felber, J.P., Golay, A. Pathways from obesity to diabetes. International journal of obesity 2002 ;26(2): S39-S45.
7. Csala, M. Hyper-free fatty acidemia-insulin resistance, and beta-cell death. Orvosi Hetilap 2016 ;157(19):733-739.
8. DeFronzo, R.A. Dysfunctional fat cells, lipotoxicity and type 2 diabetes. International journal of clinical practice 2004; 58:9-21.
9. Li, Q., Zhao, M., Wang, Y., Zhong, F., Liu, J., Gao, L., et al., Associations between serum free fatty acid levels and incident diabetes in a 3-year cohort study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2021;14:2743.
10. Li, F., Ye, J., Sun, Y., Lin, Y., Wu, T., Shao, C., et al., Distinct dose-dependent association of free fatty acids with diabetes development in nonalcoholic fatty liver disease patients. Diabetes & metabolism journal 2021; 45(3):417-429.
11. Liu, Z.X., Hong, Q., Peng, D.H., Yang, Y., Yu, W.L., Shui, H., et al., Evaluation of serum free fatty acids in chronic renal failure: evidence from a rare case with undetectable serum free fatty acids and population data. Lipids in health and disease 2019; 18(1):1-9.
12. Wang, T., Wang, Q., Wang, Z., Xiao, Z., Liu, L. Diagnostic value of combined measurement of serum Hcy, Serum Cys C, and urinary microalbuminuria in type 2 diabetes mellitus with early complicating diabetic nephropathy. ISRN Endocrinology 2013; 407452.
13. Trinder, P. Determination of glucose in blood using glucose oxidase with an alternative oxygen acceptor. Ann Clin Biochem. 1969; 6:24-27.
14. Fowler, M. J. Microvascular and Macrovascular Complications of Diabetes. Clin. Diabetes 2008; 26 (2): 77-82.
15. Okabe, H., Uji, Y., Nagashima, K., Noma, A. Enzymatic determination of free fatty acids in serum. Clin Chem. 1980; 26:1540-1543.
16. Xin, Y., Wang, Y., Chi, J., Zhu, X., Zhao, H., Zhao, S., et al., Elevated free fatty acid level is associated with insulin-resistant state in nondiabetic Chinese people. Diabetes, metabolic syndrome, and obesity: targets and therapy 2019; 12:139.
17. Zhang, L., Cui, L., Li, C., Zhao, X., Lai, X., Li, J., et al., Serum free fatty acid elevation is related to acute kidney injury in primary nephrotic syndrome. Ren Fail 2022; 44(1):1236-1242.
18. Ninomiya, T., Perkovic, V., De Galan, B.E., Zoungas, S., Pillai, A., Jardine, M., et al., Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. Journal of the American Society of Nephrology 2009; 20(8):1813-1821
Deepali S. M., J. G. Ambekar, S. M. Goornavar, Nilima Dongre, Sanjeev Ratna. Role of serum free fatty acids in determining severity of diabetic nephropathy: A case control study. Biomedicine: 2023; 43(1): 299-302