Assessment of Serum Podocalyxin as a Biomarker for Diabetic Nephropathy in Type 2 Diabetes patients in Duhok City

Abstract

Podocalyxin, a glycosylated cell surface sialomucin of the CD34 family, is a kidney podocyte membrane negatively charged protein and the essential constituent of the glomerular basement membrane charge barrier. Additionally, it has a crucial role in maintaining the glomerular filtration barrier permeability. It has been considered that one of the most important factors in diabetic nephropathy is podocyte injury. In the natural history of diabetic nephropathy and macrovascular complications, podocytes have been shown to be structurally and functionally affected. The current study aimed to determine serum podocalyxin levels in patients with type 2 diabetes mellitus and to analyse its relation to glomerular filtration rate and albuminuria. This cross-sectional study was performed at the diabetic center in Azadi Teaching Hospital and Golan Hospital in Dohuk city from September 2021 to March 2022. Consecutive sampling was applied to select 200 subjects (case group) with T2DM aged 30-65 years and 93 healthy subjects (control group). BMI, eGFR, albuminuria, HbA1c, and serum podocalyxin levels were measured for all study subjects. Serum podocalyxin levels were significantly higher in the case group (P =0.019). There was no significant difference in serum podocalyxin levels between case groups (normoalbuminuria, microalbuminuria, and macroalbuminuria). A significant negative correlation between eGFR and serum podocalyxin was found in both control and case group (P =0.010 r =-0.267, P =0.030 r =-0.154, respectively). Although S.PCX levels had a significant difference between the case and control group and a significant negative correlation with eGFR, it may not be considered as a diabetic nephropathy biomarker.