Urinary transferrin as early marker of renal damage in type II diabetes mellitus: A case–control study

Microalbuminuria is a reversible stage of renal dysfunction and its detection allows early intervention and treatment of diabetic nephropathy. Therefore, a more reliable biomarker is required to diagnose early, reversible stage of renal dysfunction. To evaluate the utility of urinary transferrin (UTRANS) as an early predictive marker in type II diabetes mellitus (T2DM). This cross-sectional study included 40 normoalbuminuric and 20 microalbuminuric T2DM patients and 20 clinically healthy controls. Materials and methods: All baseline characteristics such as glucose (fasting and postprandial), serum creatinine, HbA1c, urinary albumin, creatinine, and UTRANS were estimated. SPSS software version 20, R studio 3.6.2. Shapiro test, Chi-square test, Analysis of variance, Kruskal Wallis, and receiver operating characteristic (ROC). Urinary albumin-to-creatinine ratio and UTRANS showed a significant difference among normoalbuminuric and microalbuminuric T2DM patients compared to controls (P = 0.000). UTRANS and TRANS/creatinine ratio positively correlated in normoalbuminuric, macroalbuminuric and control groups (P < 0.05). UTRANS was an excellent to outstanding discriminator (Area under the curve: 0.8 – >0.9), indicating UTRANS was able to differentiate between healthy controls, normoalbuminuric, and microalbuminuric T2DM subjects. UTRANS may act as a potential biomarker that can be used as an early screening marker for renal injury, even before progression to the stage of microalbuminuria.