Significance of Combined Use of Natriuretic Peptides and Neutrophil Gelatinase-associated Lipocalin for Diagnosis of Renal Failure and Type 2 Diabetes Mellitus

Abstract

Background:    Both natriuretic peptides, NPs (BNP and CNP), and neutrophil gelatinase-associated lipocalin (NGAL) were reported to rise in chronic kidney disease (CKD) and type2 diabetes mellitus (T2DM). Their role in detecting and follow up of these two diseases has been well elucidated.
Objective:    To evaluate the use of a combination of NPs and NGAL in detecting renal insufficiency (per se) or early diabetic nephropathy.
Methods:    The study included 40 patients with CKD (mean age 50.63±9.25 years), 41 patients with T2DM (mean age 53.66±8.32 years) and 38 apparently healthy normal subjects (mean age 52.42±8.81 years) as controls. Natriuretic peptides, and NGAL were measured by enzyme linked immunosorbent assay (ELISA), and glycated hemoglobin (HbA1c) by fully automated boronate affinity assay. Renal function tests, glucose, and electrolytes were estimated by routine laboratory methods.
Results:    There was an increase in NGAL, N-terminal pro-C-type natriuretic peptide (NT-proCNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in both groups of patients. The HbA1c was high in the T2DM group only.  Receiver operating characteristic (ROC) curve revealed good sensitivity and specificity when using NGAL and NT-proBNP to discriminate between CKD and T2DM or between CKD and controls, or T2DM and controls.
Conclusion:    Combined use of NGAL and NT-proBNP in T2DM may be a better diagnostic marker for an early deterioration in renal function of diabetes mellitus than the HbA1c level alone.
Keywords:    Natriuretic peptides, neutrophil gelatinase-associated lipocalin, glycated hemoglobin, renal failure, diabetes mellitus
Citation:    Al-Shamma GA, Malik AS, Al-Mayah QS, Kurshead RS. Significance of combined use of natriuretic peptides and neutrophil gelatinase-associated lipocalin for diagnosis of renal failure and type 2 diabetes mellitus. Iraqi JMS. 2025; 23(2): 246-254. doi: 10.22578/IJMS.23.2.7