The Use Of Serum Levels Of Glutathione-S-Transferase For The Detection Of Diabetic Nephropathy Among Libyan Diabetics

Abstract

Introduction: Diabetic nephropathy is one of the most common and serious complications of diabetes. Microalbuminuria (MA) is a crucial risk factor for diabetic nephropathy (DN). However, recent studies have challenged the use of microalbuminuria, as albumin excretion is more likely to revert to normal levels than to macroalbuminuria. Aim: To investigate the serum levels of glutathione-s-transferase as a marker for the detection of DN among diabetic with and without DN, in combination with other biochemical parameters for checking renal function state. Material and methods: This study involved 160 subjects from the Benghazi Medical Center and the diabetic clinic of Al-hyat private center of diabetes and Benghazi Center of Diabetes and Endocrine Disease, divided into 3 groups; DN group (60 subjects), diabetic "without DN" group (60 subjects), and non-diabetic "control" group (40 subjects). blood and urine samples were collected from study participants and tested urine albumin and GST-pi levels along with other biochemical tests. Results: The mean ± SD of GST was non-significantly higher (11.3 ± 2.2 ng/ml) in the diabetic group than that of the DN group (10.8 ± 2.4 ng/ml) and the control (10.7 ± 2.2 ng/ml). Meanwhile, albumin levels were much higher in DN group (mean = 84.4 ± 59.4) than the diabetic group (10.7 ± 15.2) and the control (5.2 ± 1.3). Regarding kidney function tests; the means of blood urea, serum creatinine and uric acid were significantly higher in diabetic nephropathy group than the diabetic group and the control group. Conclusion: The present study showed a nonsignificant elevation in serum levels of GST-Pi. The level of the enzyme was higher in diabetics without diagnosed nephropathy than that of DN group, this increase may be occurred as a compensation to the undiagnosed deterioration of kidney function. Future work using large number of samples are required to confirm the role of GST as an early biomarker of DN. Keywords: Glutathione-s-transferase, GST, Diabetic nephropathy, Microalbuminuria