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Assessment of two novel renal tubular proteins in type 2 diabetic patients with nephropathy
  1. Muhammad Tarek Abdel Ghafar1,
  2. Khaled Hamed Shalaby2,
  3. Hanaa Ibrahim Okda2,
  4. Rehab E Abo El gheit3,
  5. Nema Ali Soliman4,
  6. Walaa Arafa Keshk4
  1. 1 Clinical Pathology, Tanta University Faculty of Medicine, Tanta, Egypt
  2. 2 Internal Medicine, Tanta University Faculty of Medicine, Tanta, Egypt
  3. 3 Physiology, Tanta University Faculty of Medicine, Tanta, Egypt
  4. 4 Medical Biochemistry, Tanta University Faculty of Medicine, Tanta, Egypt
  1. Correspondence to Dr Muhammad Tarek Abdel Ghafar, Clinical Pathology, Tanta University Faculty of Medicine, Tanta 31511, Egypt; mohammedtarek5514{at}


Nephropathy is a common health issue associated with type 2 diabetes mellitus (T2DM). Treatment of diabetic nephropathy (DN) in an early stage can effectively inhibit its progression. Albuminuria is the currently accepted marker for detection of DN.This study aims to evaluate the urinary level of two novel renal tubular proteins (cyclophilin A and periostin) in patients with T2DM and among different nephropathy stages and also to validate the diagnostic accuracy of both cyclophilin A and periostin as potential markers for early prediction of DN relative to albuminuria.This cross-sectional study recruited 137 patients with T2DM, and they were divided based on their urinary albumin:creatinine ratio into T2DM with normoalbuminuria (group II), incipient T2DN with microalbuminuria (group III) and overt T2DN with macroalbuminuria (group IV) beside 41 healthy subjects as group I. Cyclophilin A and periostin were measured in the urine using ELISA. Diagnostic accuracy of both markers was determined for prediction of DN via receiver operating characteristic curve analyses.Urinary cyclophilin A and periostin levels were significantly higher in DN groups when compared with T2DM with normoalbuminuria group. For prediction of incipient and overt DN, areas under the curve (AUCs) of periostin were 0.954, 0.997 and cyclophilin A were 0.914, 0.937, respectively. AUCs of periostin were higher than that for cyclophilin A with a significant AUC difference (p=0.022) in overt DN stage.Periostin and cyclophilin A could be regarded as a potential urinary biomarker for early prediction of DN. Periostin exhibits a higher diagnostic accuracy than urinary cyclophilin A specifically in overt DN stage.

  • Diabetes Complications
  • Diabetes Mellitus
  • Diabetic Nephropathies
  • diagnostic tests, routine
  • Proteinuria

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  • Contributors All authors contributed in the writing of this manuscript. The study was designed by MTAG. Patient selection and clinical evaluation were performed by KHS and HIO; laboratory investigations by MTAG, NAS and WAK; and data analysis by REAEg.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval Study protocol was approved by the ethics committee of Tanta Faculty of Medicine.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.