Speaker
Description
Background: The diagnosis of microalbuminuria remains the gold standard for confirming early diabetic nephropathy. However, emerging studies indicate that microalbuminuria is typically identified after a significant glomerular damage has occurred. Hence, there is a need for more sensitive and accurate biomarkers for predicting early nephropathy among Type 2 Diabetes (T2DM). Tubular damage markers increase in patients with diabetes mellitus even before diagnosis of microalbuminuria. Beta-2 Microglobulin(B2M) is an excellent assay for detecting tubular injury. Neutrophil -Lymphocyte Ratio (NLR) is a known prognostic and predictive marker of early DN. Both markers have not been fully studied in Ghana. The study sought to evaluate NLR and B2M as early predictors of Nephropathy among T2DM as compared to Microalbumin(Albumin -Creatinine Ratio).
Methods:This was a hospital-based cross-sectional study. NLR was calculated from a ratio absolute neutrophil and lymphocyte count. B2M level was determined using ELISA technique. Estimated Glomerular Filtration Rate (eGFR) was used as an independent marker to indicate kidney disease (≤60mL/min/1.73m²).
Results: The prevalence of nephropathy among subjects was 7.0%. with 64.3% mild, 21.4% moderate, and 14.3% severe cases. Occupation (p = 0.044) and monthly exercise (p = 0.040) were significantly associated with nephropathy. Nephropathy cases had higher age (p = 0.006), urea (p < 0.001), creatinine (p < 0.001), and lower eGFR (p < 0.001) and hematocrit (p = 0.043) ROC analysis revealed poor diagnostic predictive performance: B2M was highly specific (91.4%) but had poor sensitivity (28.6%) and NLR demonstrated a very high sensitivity (92.9%) but very low specificity (29.6%).
Conclusion: NLR and B2M could not significantly predict nephropathy among T2DM. However, B2M exhibited high specificity but low sensitivity, while NLR demonstrated high sensitivity with low specificity.