SERUM OSTEOGLYCIN ASSAY AS AN EARLY MARKER IN DIAGNOSIS OF DIABETIC NEPHROPATHY AND ITS CORRELATION WITH DIFFERENT CKD STAGES

*Dr. Narendra Pulukuri MBBS, Dr. Prasanna Kumar HR MBBS, M.D, FICP, Dr. Tejashree A. MBBS, M.D, Dr. Shasidhara KC MBBS, M.D, Dr. Srinath KM, MBBS, M.D. and Dr. Manthappa M. MBBS, M.D.

ABSTRACT

Context: Glomerular impairment is also evident in diabetic normoalbuminuric patients, which might progress to advanced stages of CKD. Studies on osteoglycin which is an SLRP suggested that it has a role in pathogenesis of Nephropathy and its level could be assessed as a viable marker for diagnosing and identifying progression of nephropathy. Aims: To Assess and correlate the relation between levels of serum osteoglycin as a potential novel biomarker in the early diagnosis of Diabetic Nephropathy and correlating it with different CKD stages. Settings and Design: Cross sectional observation study. Material and Methods: It was conducted on 120 eligible subjects, who are divided into control and diabetes groups, subjects in diabetes group are further divided into 3 groups based on urine microalbumin creatinine ratio as normoalbuminuric, microalbuminuric and microalbuminuric and they are further divided into 5 CKD stages based on their eGFR calculated by CKD EPI equation. Serum osteoglycin levels were estimated in all the groups using an ELISA kit. Statistical analysis used: Comparison among different diabetes and control group was done using ANOVA (Analysis of variants) followed by post hoc comparison, ROC curve, multivariate analysis. Results: Our study showed that Serum osteoglycin levels can detect microalbuminuria in diabetes group with a sensitivity of 83.78% and specificity of 86.67% and its levels were low in stage 1 CKD they increase up to stage 3b CKD and as the disease progresses, they are decreased in stage 4 and 5 CKD. Conclusion: Osteoglycin has the potential to be an early marker for screening diabetic patients who are at risk for developing nephropathy and might also be helpful in assessing the progression of nephropathy as the changes in its levels were evident in different CKD stages However, as studies on osteoglycin levels in diabetic nephropathy are limited understanding the exact mechanism requires further research to establish it as a novel biomarker.

Keywords: Osteoglycin, diabetic nephropathy, microalbuminuria, Chronic kidney disease, Biomarker, SLRP-small leucine rich peptide.