Study of microalbuminuria as early risk marker of nephropathy in type 2 diabetic subjects

Manish K. Verma, Pradeep Kumar, Preeti Sharma, V. K. Singh, Shashi Prabha Singh



Background: Diabetic nephropathy (DN) is a common complication of diabetes mellitus that lead to end-stage of kidney disease (ESKD). Detection of early-stage can slow loss of kidney function and improve patient outcomes with use of diagnostic biomarker detection of DN. Aims and objectives of this study is to evaluate the possible association between glycated hemoglobin and urinary microalbumin as a predictor of diabetic nephropathy in type 2 diabetic patients.

Methods: Total 162 subjects were included in this study comprises uncontrolled diabetes 54 cases, controlled diabetes 54 cases and healthy controlled 54 controls. Micro albumin was measured by urinary microalbumin (turbidimetric immunoassay), glycated hemoglobin (HbA1c) measured by ion exchange resin method and fasting blood glucose estimated by GOD-POD method. The inclusion of age group was between 35 to 74 years. Statistical analysis was done by using SPSS, version 16.0. p values were calculated by ANOVA unpaired t-test. The p<0.05 was considered a statistically significant.

Results: Urinary microalbumin levels were statistically significant increase in type 2 diabetes mellitus with nephropathy in comparison to uncontrolled diabetes mellitus and controlled diabetes mellitus (138.9±13.7 mg/l vs 67.7±14.1 mg/l and p<0.005**).  HbA1c, which acts as a biomarker of diabetes was significant higher diabetic nephropathy, in comparison to uncontrolled diabetes mellitus, controlled diabetes mellitus and healthy control (8.0±1.1% vs 7.1±0.9% and 5.7±0.4%).

Conclusions: The present study was demonstrated impaired glycaemic control is associated with elevations in urinary micro albumin levels and it may be considered as risk marker of diabetic nephropathy.


Biomarker, Controlled diabetes mellitus, Glycosylated hemoglobin (HbA1c), Urinary microalbumin, Uncontrolled diabetes mellitus

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Battisti WP, Palmisano J, Keane WE. Dyslipidemia in patients with type 2 diabetes: relationships between lipids, kidney disease and cardiovascular disease. Clin Chem Lab Med. 2003;41:1174-81.

Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(1):5-20.

Ninomiya T, Perkovic V, Ds Galan BE, Zoungas S, Pillai A, Jardine M, et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol. 2009;20:1813-21.

Go AS, Chertow GM, Fan D, McCulloch CE, Hsu C. Chronic Kidney Disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004; 351(13):1296-305.

De Boer IH, Rue TC, Hall YN, Heagerty PJ, Weiss NS, Himmelfarb J. Temporal trends in the prevalence of diabetic kidney disease in the United States. Jama. 2011;305(24):2532-9.

Alam R, Verma MK, Verma P. Glycated hemoglobin as a dual biomarker in type 2 diabetes Mellitus predicting glycaemic control and dyslipidemia risk. Int J Life Sci Scienti Res. 2015;1(2):62-5.

Verma M, Alam R, Mobin M. Review on malondialdehyde and superoxide dismutase levels in patients of type 2 diabetes mellitus with retinopathy and without retinopathy. Int J Life Sci Scienti Res. 2015;1(2):52-7.

Verma M, Verma P, Parveen S, Dubey K. Comparative study of lipid profile levels in vegetarian and non-vegetarian person. Int J Life Sci Scienti Res. 2015;1(2):89-93.

Tripathi P, Verma MK, Tripathi SS, Singh SP. Comparative study of malondialdehyde and vitamin c in type 2 diabetes mellitus and non-diabetic individuals. Int J Life Sci Scienti Res., 2016;2(1):9-14.

Verma MK, Singh SP, Alam R, Verma P. Comparative study on MDA, SOD and Hba1c levels in patients of type 2 diabetes mellitus with retinopathy and without retinopathy. Int J Pharm Sci Res. 2016;7(10):4184-90.

Singh PS, Verma MK, Tripathi P, Singh D. Study of oxidant (MDA) and antioxidants (SOD and Vitamin E) in hypertensive patients and normotensive individuals. Int J Life Sci Scienti Res. 2016;2(1):9-14.

Mogensen CE, Christiansen CK. Predicting diabetic nephropathy in insulin dependent patients. N Engl J Med. 1984;311:89-93.

Raij L. Recommendations for the management of special populations: renal disease in diabetes. Am J Hypertens. 2003;16:46S-9.

GK T, Sharma R, Verma MK, Sharma P, Kumar P. Biomarkers in serum uric acid as a risk factor for type 2 diabetes associated with hypertension. Asian J Pharm Clin Res. 2016;9(2):352-5.

Nathan DM, Singer DE, Hurxthal K, Goodson JD. The clinical information value of the glycosylated hemoglobin assay. New England J Med. 1984;310(6):341-6.

Varly H, Gowenlock AH, Bell M. Practical clinical biochemistry. 5th Ed. 1980;650-657.

Mount JN. Turbidimetric test for the quantitative determination of microalbuminuria in human urine. J Clin Pathol. 1986;22:12.

Al-Sheikh A. Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetic clinic in Abualaziz university hospital. Pak J Med Sci. 2000;23(2):223-6.

Maiti A, Dey SK, Raychaudhuri P, Sinha PK, De J, Chatterjee A, et al. ‘‘Changes in microalbuminuria in relation to glycosylated haemoglobin (HbA1c) and duration in type 2 diabetes mellitus’’. Indian Med Gazette. 2012;394-9.

Raile K, Galler A, Hofer S, Herbst A, Dunstheimer D, Busch P, et al. Diabetic nephropathy in 27805 children, adolescents and adults with type 1 diabetes: effect of diabetes duration, A1c, hypertension, dyslipidaemia, diabetes onset and sex. Diabetes Care. 2007;30:2523-8.

Use of glycated haemoglobin and microalbuminuria in the monitoring of diabetes mellitus; abbreviated report of a WHO consultation. Summary, Evidence report/technology assessment: number 84. AHRQ, 2003. Available at epcsums/glycasum.htm.

Maiti A, Dey SK, Raychaudhuri P, Sinha PK, De J, Chatterjee A, et al. The pattern of diabetic nephropathy in Saudi Arabia patients with NIDDM. Ann Saudi Med. 1995;15:120-4.

Nelson RG, Knowler WC, Pettitt DJ, Hanson RL, Bennett PH. Incident and determinants of elevated urinary albumin excretion in Pima Indians with NIDDM. Diabetes Care. 1995;18:182-7.