Comprehensive Inflammatory Biomarker Profiling In Diabetic Nephropathy: Identifying Key Indicators For Early Diagnosis And Therapeutic Intervention

Abstract

Background
Diabetic nephropathy (DN) remains a major microvascular complication of Type 2 Diabetes Mellitus (T2DM), arising from chronic hyperglycemia, inflammation, and oxidative stress. DN significantly contributes to end-stage renal disease worldwide, emphasizing the need for early detection and targeted management strategies.

Objective
This study aimed to compare metabolic, renal, and inflammatory markers between individuals with diabetic nephropathy and those without nephropathy to identify key biomarkers and pathophysiological factors that differentiate the two groups.

Methods
A cross-sectional comparative study was conducted at Dr. Kiran C. Patel Medical College and Research Institute, recruiting 200 participants over 12 months. One hundred participants were diagnosed with DN based on albuminuria and reduced eGFR, while 100 individuals with diabetes but without nephropathy served as controls. Demographic data, metabolic parameters (FBS, PP2BS, HbA1C), renal indices (creatinine, eGFR, microalbumin, cystatin C), and inflammatory/oxidative markers (IL-10, Fetuin-A, OxLDL, Adiponectin, Total Antioxidant Status) were measured and analyzed. Statistical tests included independent t-tests, chi-square tests, and multiple regression models, with significance set at p < 0.05.

Results
Compared to controls, the DN group exhibited significantly higher glycemic indices (FBS: 178.96 ± 16.35 vs. 90.83 ± 10.63 mg/dL; HbA1C: 8.05 ± 1.68% vs. 4.39 ± 0.76%; both p < 0.001) and markedly impaired renal function (eGFR: 39.2 ± 14.3 vs. 96.7 ± 9.5 mL/min/1.73 m²; p < 0.001). Inflammatory markers such as IL-10 (15.98 ± 4.48 pg/ml), Fetuin-A (102.77 ± 14.16 ng/ml), and OxLDL (149.56 ± 137.67 ng/ml) were elevated in the DN group (all p < 0.01), whereas Total Antioxidant Status was substantially lower (312.14 ± 169.37 vs. 887.52 ± 116.93; p < 0.001). Regression analyses did not identify a single biomarker as the dominant predictor of eGFR or HbA1C but highlighted the complex and multifactorial nature of DN.

Conclusion
The study underscores a strong association between advanced kidney dysfunction and chronic inflammation, oxidative stress, and poor glycemic control in patients with diabetic nephropathy. These data reinforce the importance of an integrated therapeutic approach that addresses metabolic control and inflammatory-oxidative pathways to delay DN progression.