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Subject Area

Family Medicine

Article Type

Original Study

Abstract

Objective The aim was to evaluate serum obestatin level in type 2 diabetic patients with diabetic kidney disease as a diagnostic and a prognostic marker. Background Obestatin has been reported to have important effects on endothelial cells as decreasing vascular cell adhesion molecule-1 expression and increasing oxidized low-density lipoprotein binding to the macrophage. Participant and methods A cross-sectional study was carried out on 100 patients sin the Department of Internal Medicine, Menoufia University Hospitals. A total of 100 patients was divided into different groups. Group I: 25 type 2 diabetic patients with normoalbuminuric; group II: 25 type 2 diabetic patients with microalbuminuria; group III: 25 type 2 diabetic patients with macroalbuminuria; and group IV: 25 healthy individuals as a control group. All participants were subjected to history taking, complete physical examination, anthropometric measurement, waist circumferences, fasting blood glucose, 2h-postprandial blood glucose, glycated hemoglobin, kidney function tests, estimated glomerular filtration rate, urine analysis, abdominal ultrasound, liver profile, lipid profile, complete blood count, and serum obestatin level by ELIZA kit. Results Obestatin was 2.9 ± 0.4 ng/dl in group I, 3.7 ± 0.7 g/dl in group II, 5.5 ± 0.9 g/dl in group III, and 2.4 ± 0.6 g/dl in group VI. These results were significantly higher in group III than in groups I, II, and VI (P < 0.001). At cutoff greater than 4.4 obestatin level was a significant excellent power of discrimination between microalbuminuria and macroalbuminuria (area under the curve = 0.970, P < 0.001) with a sensitivity of 96.0% and a specificity of 84.0% and at a cutoff greater than 3.3; obestatin significant good power of discrimination of microalbuminuria from macroalbuminuria (area under the curve = 0.829, P < 0.001) with a sensitivity of 72.0% and a specificity of 92.0%. Conclusion Higher serum levels of obestatin were associated with macroalbuminuria, suggesting that obestatin may have a role in the underlying pathogenic mechanisms that lead to diabetic kidney disease.

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