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 patients. So, in this study, we are exploring the diagnostic and prognostic potential of galectin-3 for the early detection of diabetic nephropathy.To assess the diagnostic and prognostic potential of galectin-3 and growth differentiation factor-15 (GDF-15) in patients with diabetic nephropathy.

METHODS: This was an observational study conducted at Hakeem Abdul Hameed centenary hospital, Jamia Hamdard. Study period was of 1.2 years. The study protocol was approved by the Jamia Hamdard 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 and prognostic potential of galectin-3 and GDF-15 in patients with diabetic nephropathy. Its sensitivity and specificity were 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). Galectin-3 and GDF-15 levels were significantly elevated in T2DM patients with macroalbuminuria (p = <0.05). The patients with poor kidney function (Stage IV-V CKD) had higher levels of galectin-3 and GDF-15. 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 of galectin-3 yielded an AUC of 0.776 (95% CI: 0.677 to 0.875; p = <0.0001) and an AUC of 0.963 (95% CI: 0.929 to 0.997; p = <0.0001) for GDF-15.

CONCLUSIONS: In diabetic nephropathy patients, the galectin-3 and GDF-15 levels were inversely related to the eGFR. ROC curve also demonstrates the diagnostic and prognostic potential of galectin-3 and GDF-15 in diabetic nephropathy patients.