Huda Farhan Ahmed
College of Health and Medical Technologies, Middle Technical University- Baghdad, Iraq
Shatha Hamed Jwaid
College of Health and Medical Technologies, Middle Technical University- Baghdad, Iraq
Hanadi Hendi Khudair
College of Health and Medical Technologies, Middle Technical University- Baghdad, Iraq
ABSTRACT
Background: Diabetic kidney disease (DKD) is recognised as one of the most frequent and severe complications of diabetes mellitus, contributing significantly to morbidity and mortality worldwide. Identifying reliable biomarkers that can reflect disease progression remains a critical challenge. Objective: This study aimed to evaluate the diagnostic potential of Macrophage Inhibitory Cytokine-1 (MIC-1) and Protein Phosphatase 2A (PP2A), alongside oxidative stress markers and biochemical variables, in patients with chronic kidney disease (CKD) with and without diabetes. Materials and Methods: A total of 150 participants were enrolled: 50 with CKD and type 2 diabetes mellitus (G1), 50 with CKD without diabetes (G2), and 50 healthy controls (G3). Biochemical parameters, including cholesterol, triglycerides, HDL, LDL, and fasting blood sugar (FBS), were measured using a CS-T180 automated biochemical analyser. HbA1c was assessed using an icroma instrument. Serum MIC-1, insulin, PP2A, SOD, GSH-Px, and LPO levels were quantified by ELISA. HOMA-IR and estimated glomerular filtration rate (eGFR) were calculated. Results: Age and sex distribution did not differ significantly between groups. Patients in both CKD groups demonstrated significantly higher FBS, urea, creatinine, lipids, and HbA1c compared to controls (P < 0.01), with eGFR markedly reduced. Haemoglobin, iron, and ferritin levels were significantly lower in diabetic CKD patients. MIC-1 and PP2A levels varied strongly across groups (P < 0.0001), with diabetic CKD patients showing the highest elevations. Insulin and HOMA-IR levels were also significantly increased in diabetic patients. Receiver operating characteristic (ROC) analysis revealed that MIC-1 and PP2A had strong diagnostic accuracy, with AUC values ranging from 0.96 to 0.98. Conclusion: The study demonstrates that MIC-1 and PP2A are significantly elevated in diabetic CKD patients and correlate with disease severity, highlighting their potential as valuable biomarkers for the early detection and monitoring of diabetic kidney disease. Incorporating these markers alongside traditional biochemical parameters may enhance diagnostic precision and improve disease management.
Keywords: DKD, MIC-1, PP2A SOD, GSH-Px, and LPO.
