OBJECTIVES: Evidence from published studies raised doubt on microalbuminuria as a predictive marker for the development and progression of kidney disease in type 2 diabetes mellitus (T2DM) patients. So, this study aimed to assess the predictive potential of galectin-3 and growth differentiation factor-15 (GDF-15) for the early detection of DKD.

METHODS: This was an observational study conducted at Hakeem Abdul Hameed Centenary Hospital (HAHC), New Delhi, India. Study period was of 1.2 years. The study protocol was approved by the Institutional Ethics Committee. Patients were classified on the basis of estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio. Receiver operating characteristic (ROC) curve was plotted to assess the diagnostic potential of the marker, sensitivity and specificity was also calculated. All the analysis was performed using SAS v9.4.

RESULTS: A total of 90 patients completed the study. Patients were grouped as normoalbuminuria (30 patients), microalbuminuria (30 patients), and macroalbuminuria (30 patients). Mean age of the patients were 58.5 ± 11.20 years. Galectin-3 and GDF-15 levels were significantly elevated in T2DM patients with macroalbuminuria (p = <0.05). Higher levels of galectin-3 and GDF-15 were found in patients with poor kidney function (Stage IV-V CKD). Negative correlation was observed between galectin- 3 (r = -0.472) and eGFR (p= 0.000), GDF-15 (r = -0.917) and eGFR (p = 0.000). The ROC analysis yielded an area under curve (AUC) of 0.776 (95% CI: 0.677 to 0.875; p = <0.0001) for galectin-3 and an AUC of 0.963 (95% CI: 0.929 to 0.997; p = <0.0001) for GDF-15.

CONCLUSIONS: In DKD patients the galectin-3 and GDF-15 levels were inversely related to the eGFR which was further confirmed by the ROC curve demonstrating the potential of galectin-3 and GDF-15 as a biomarker.