Markers for Early Detection of Renal Impairment in Various Glucose Tolerance Abnormalities
Issue : Salkova, Martina I., Tankova, Tsvetalina I.
Abstract:
Diabetes mellitus is a metabolic disease that is spreading at pandemic rate worldwide. For this reason, increasing attention is being drawn to its prevention and associated chronic complications. In this regard, prediabetic states, which represent an intermediate stage in the transition between normal glucose homeostasis and diabetes mellitus, have been examined with particular interest in recent years. Microvascular complications – diabetic retinopathy and nephropathy are affecting a substantial proportion of patients with diabetes mellitus and, according to the literature data, this amounts to about 25-40%. Their high rate and impact on quality of life and socioeconomic consequences demonstrate the important role of prevention of microvascular complications not only in the diabetic patient population but also in the group with impaired glucose tolerance. The main risk factors for the development of diabetic nephropathy are considered to be the long duration of diabetes mellitus, poor glycaemic control, arterial hypertension, dyslipidaemia, increased waist circumference, being overweight and obese, age, gender and family predisposition. Part of these are components of metabolic syndrome and are typical for the high-risk population with prediabetes. This is a subject of interest due to the presence of well known pathophysiological defects which characterize type 2 diabetes mellitus and are also observed in the development of prediabetic conditions. For this reason, research on the relationship between the development of diabetic nephropathy and the presence of prediabetes is well-founded. In recent years, the focus has shifted to finding early biomarkers to enable early diagnosis, prevention of the spread and slowing the progression of nephropathy that has already developed. Cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), homocysteine, E-cadherin and fetuin-A have emerged as such biomarkers.
