Insulin resistance and specific biomarkers in blood and urine of type 2 diabetic patients with or without nephropathy in Basrah, Iraq

Diabetic nephropathy (DN) is a master cause of all surplus death-rate among type 2 diabetes mellitus (T2DM) patients with microalbuminuria. This study aimed to find effective biomarkers for early predicting of DN. Present study included 63 patients with T2DM (31 patients with DN, 32 patients without DN) and 33 healthy controls. These three groups were matched for their glucose, urea, creatinine, insulin, L-Carnitine (LC), osteoprotegerin (OPG), sialic acid (SA), trace elements (Selenium, Zinc, Magnesium), albumin (Alb), and fibronectin (FN). Glucose, urea, and creatinine were determined by spectrophotometer. Insulin, LC, OPG, SA, Alb, and FN were assayed by enzyme-linked immunosorbent assay (ELISA). Insulin resistance (IR) was calculated by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) equation. Selenium was measured by hydride generation while Zinc and Magnesium were measured by flame atomic absorption spectrometer. Compared with controls, the results indicated that T2DM patients with or without DN had a significant increase in glucose, urea, creatinine, insulin, IR, OPG, SA, Alb, FN and a significant decrease in LC and trace elements levels. It was concluded that IR is strongly associated with obesity and had an important role in the pathogenesis and increased complication of diabetes which could be used as excellent indicators for early-stage DN in T2DM patients and thus decreasing mortality and morbidity.   Key words: Diabetic nephropathy, insulin resistance, obesity, oxidative stress, traces elements.