Assessment of Serum and Urine Neurophil Gelatinase- Associated Lipocalin (s-NGAL and u-NGAL) Level as a Predictive Factor of Disease Progression in Diabetic Nephropathy in Type 2 DM.

INTRODUCTION: Diabetic nephropathy (DN) is a major complication of diabetes Mellitus. Early detection and intervention of DN can slow its progression and improve patients' outcomes. Neutrophil gelatinase-associated lipocalin (NGAL) as a marker of tubular damage might become a useful biomarker for the evaluation of renal involvement in diabetic patients. We aimed to evaluate the serum and urine NGAL(s-NGAL and u-NGAL) in type 2 diabetic patients and its correlation with different stages of diabetic nephropathy. METHODS: This cross-sectional study was designed on 198 subjects consisted of 50 controls and 148 type 2 diabetes patients (50 normoalbuminuric, 58 microalbuminuric, and 40 macroalbuminuric). The study was conducted with measuring s-NGAL and u-NGAL, albumin and spot urine creatinine were also measured. RESULTS: A highly increased level of s-NGAL was detected in macroalbuminuric group compared with controls, normoalbuminurics and microalbuminurics (P < .01). Highly raised u-NGAL levels were observed in macroalbuminurics in comparison with controls (P < .01). ROC curve demonstrated the best sensitivity and specificity of s-NGAL/u-NGAL for the macroalbuminuric state (sensitivity, 26% and 60%; specificity, 98% and 72%; respectively), in which the best cut-off points for the detection of macroalbuminuric state for s-NGAL/u-NGAL were 300 ng/mL and 71.4 ng/mL, respectively. CONCLUSION: Serum and urine-NGAL are elevated in type 2 diabetic patients, with or without albuminuria, s-NGAL level clearly correlates with severity of renal damage caused by DN and u-NGAL increases in macroalbuminuric state. S-NGAL could be a useful, noninvasive, available and practical test for evaluation of diabetic renal involvement. We could suggest u-NGAL as a probable predictor of macroalbuminuria.

Effects of Ramadan on food intake, glucose homeostasis, lipid profiles and body composition composition.

BACKGROUND/OBJECTIVES: Changes in food consumption patterns during Ramadan may cause metabolic changes, but these have not been well studied. We aimed to determine food intake, glucose homeostasis, lipid profiles, and body composition before, during, and after Ramadan fasting. METHODS: 160 healthy men were enrolled and investigated at three times (before, at the end of, and 1 month after Ramadan). Body composition was estimated by bio-impedance. Fasting blood samples were obtained for measuring fasting blood sugar (FBS), lipid profiles and insulin level. Insulin resistance (IR) was identified by the homeostatic model assessment (HOMA) of peripheral IR. Food intake was measured using a validated food frequency questionnaire before and during Ramadan. Statistical analysis was performed by SPSS 16 and P < 0.05 considered the level of significance. RESULTS: Anthropometric parameters such as body weight, body mass index, and body fat percentage (BFP) as well as FBS and circulating triglycerides were all decreased significantly at the end of Ramadan compared with the same indices measured prior to Ramadan (all P < 0.001). In contrast, at the end of Ramadan, HOMA-IR was significantly elevated (P < 0.001). One month after Ramadan, these traits had all started to return to their pre-Ramadan levels, but were still disrupted. Food intake of all food groups except carbohydrates were decreased during Ramadan. CONCLUSION: Ramadan fasting may lead to both positive and negative health effects such as a decrease in FBS, weight, BFP, and increase in LDL and IR in healthy adults. However, these effects were all transitory.