PENTOSIDINE AS A BIOMARKER FOR KIDNEY MICROVASCULAR COMPLICATION IN TYPE 2 DIABETIC PATIENTS

Background: Pentosidine is a florescent member of advanced glycation end products (AGEs). Serum soluble receptor for advanced glycation end product (sRAGE) may reflect the activity of the advanced glycation end product (AGE)–receptor for advanced glycation end product (RAGE) axis, which has been proposed as a potential mechanism linking hyperglycaemia to vascular complications in diabetes. Objectives: We have investigated whether pentosidine levels was increased and correlated with kidney microvascular complications (nephropathy) in type 2 diabetes mellitus (DM). Patient and method: Twenty healthy control subjects, and 40 diabetic patients (20 patients with normo-albuminuria and 20 patients with micro-albuminuria) were included in the study. Pentosidine was measured in serum by enzyme-linked immune sorbent assay (ELISA). Results: Serum pentosidine level was significantly increased in diabetic patients (both with normoalbuminuria and microalbuminuria ) compared to control subjects (p< 0.001). Serum pentosidine levels were positively associated with nephropathy in type 2 DM. No statistical correlation between serum pentosidine and fasting blood glucose level (r=0.298 ,p=0.21) nor HbA1c% (r=0.13,p=0.59) were found but there was positive correlation between serum pentosidine and urinary albumin excretion (r=0.636, p=0.003) in microalbuminuric diabetic patients group. Positive correlation between serum pentosidine level and urinary creatinine with a long duration of diabetes mellitus (12.5± 1.79 years) was also found. At a cut off value of 312.5 pg/ml pentosidine showed a sensitivity of 85%, a specificity of 87.5%, with a positive predictive value of 77.3%, negative predictive value of 92.1% and AUC=0.95 in detecting microalbuminuria. Conclusion: Pentosidine levels is a good biomarker for kidney microvascular complication in type 2 diabetic patients.