GAMMA GLUTAMYL TRANSFERASE AS A PREDICTIVE MARKER OF MICROALBUMINURIA IN DIABETIC NEPHROPATHY

*Dr. Muhammad Haroon Mujtaba Memon MBBS, Dr. Waqas Memon MBBS, Dr. Shahzeem Shoukat Memon MBBS, Dr. Ramsha Fazal MBBS and Dr. Abeer Rafique MBBS, FCPS

ABSTRACT

Objective: To determine predictive value of gamma glutamyl transferase (ϒ-GT) for microalbuminuria in diabetic nephropathy. Study Design: Case control study. Place & Duration: Department of Medicine –Jinnah Post Graduate Medical Center, Karachi from December 2015- August 2016. Subjects & Methods: 45 healthy controls and 55 type 2 diabetics were selected through non-probability purposive sampling. Microalbuminuria can be diagnosed from a 24-hour urine collection. BUN, serum creatinine, albumin, bilirubin, uric acid, blood glucose, HbA1c, serum creatinine and blood lipids were analyzed. Urinary albumin was estimated by immunoturbidometry method and ϒ-GT by IFCC method. Data was analyzed by statistical package SPSS 22.0 and Graph Pad Prism. Results: Albuminuria and ϒ-GT in controls and cases were found as 19.73±5.21 and 150.47± 102.43 mg/dL and 21.62±5.36 and 36.27± 6.33 U/L (P=0.001) respectively. ϒ-GT showed positive correlation with Microalbuminura (r= 0.871, P=0.0001). ϒ-GT, on linear regression model, predicted the microalbuminuria, F= 221.82, P= 00001, R2 = 0.694. In binary logistic regression analysis, ϒ-GT was strongly predicted the microalbuminuria (AUC=0.914, Odd ratio= 1.366, P = 0.0001). Conclusion: The ϒ-GT may be used as alternative screening test for predicting the microalbuminuria in type 2 diabetics. ϒ-GT levels along with urinary albumin may help in early detection of diabetic nephropathy.

Keywords: ?-Glutamyl transferase Microalbuminuria Diabetic nephropathy.