Association between serum spexin levels and diabetic nephropathy in patients with type 2 diabetes: a cross-sectional study.

Background: Diabetic nephropathy (DN) is a serious complication of diabetes, with a high prevalence ranging from 21.8% in China, 35.3% in African countries, and an overall prevalence of 20-40% worldwide. This study investigated serum spexin levels in patients with type 2 diabetes, comparing those with and without DN, and explored its association with metabolic parameters.

Methods: This cross-sectional study was conducted among patients with type-2 diabetes according to ADA guidelines. After obtaining informed consent, urine albumin-to-creatinine-ratio (ACR) was determined and patients were categorized into two groups: with-nephropathy (ACR ≥ 30) and without-nephropathy (ACR < 30). The correlation between spexin and demographic, anthropometric, and biochemical variables was further determined. Logistic regression analysis was used to assess the relationship between spexin and the likelihood of DN. Receiver Operating Characteristic (ROC) curve analysis determined the optimal serum spexin cutoff for distinguishing between groups.

Results: A total of 97 diabetic individuals (33 with DN, 64 without) participated in the study. Serum spexin was significantly lower in patients with DN compared to those without DN (p < 0.001). Spexin concentrations showed an inverse correlation with LDL and ACR levels. Lower spexin levels were associated with a reduced likelihood of DN (OR 0.46, 95% CI 0.31-0.69; p < 0.001). ROC curve analysis identified a cutoff value of 81.10 ng/ml, with an area under the curve of 0.986, demonstrating 95.3% sensitivity and 94.1% specificity for diagnosing DN.

Conclusion: Lower serum spexin levels are associated with impaired kidney function, indicating its potential as a predictive biomarker for diabetic nephropathy. However, further validation in larger and more diverse cohorts is needed to address limitations such as sample size and unmeasured confounders.