Plasma Growth Differentiation Factor 15 and Advanced Glycation End Product (AGEs) in Diagnosis and Evaluation of Type 2 Diabetic Nephropathy

Maha T. Mohamed, Iglal M. Shawky, Mahmoud S. Abdel Aleem, Mahmoud R. Mohamed, Hend M. Moness


Objective: Diabetic nephropathy (DN) is considered one of the leading causes of end stage renal disease. The study was done to detect the plasma level of growth differentiation factor 15 and advanced glycation end products in patients of type 2 diabetic nephropathy and to assess their value in diagnosis and evaluation of type 2 diabetic nephropathy. Design: A cross-sectional study was conducted. Subjects: Current study included 150 type 2 diabetic patients and 30 apparently healthy subjects after informed written consent. Intervention: Patients are classified into normoalbuminuria, microalbuminuria and macroalbuminuria. Results: GDF-15 and AGES levels were significantly increased in type 2 diabetic patients and also, increased with the progression of albuminuria and diabetic nephropathy. Result of the ROC curve analysis of GDF-15 in prediction of renal dysfunction revealed that the optimum cutoff point is >38.6 (pg/ml), the area under curve was 84.0%, with a high significance (p. <0.001) and with a high sensitivity (81.3%), Specificity (80.0%). ROC curve analysis of AGES in prediction of renal dysfunction revealed that the optimal Cutoff point was ≥ 7.7 (pg/ml), the area under curve was 88.0%, with a high significance (p. <0.01) and with a high sensitivity (85.3%), Specificity (86.3%). Conclusion: GDF-15 and AGES had a high value in early diagnosis, evaluation and prediction of type 2 DN. with high sensitivity and specificity.


Growth differentiation factor 15; advanced glycation end products; diabetic nephropathy; microalbuminuria; end stage renal disease.


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