Mohamed Mohamed Ismail, Sally kamal Ibrahim and Al Shaymaa Ahmed Ibrahim
Introduction: Type 1 diabetes mellitus is an autoimmune disease affecting children worldwide with many consequences disturbing their quality of life. Diabetic nephropathy is among the most important complications of T1DM. The reliability of albuminuria as a predictor and prognosticator for renal injury has been frequently questioned. Many markers were investigated to replace urinary albumin. The current study aimed to assess the potential value of urinary Smad1 as a new biomarker for the early diagnosis and assessment of severity of diabetic nephropathy in children with.
Material and method: A case control cross sectional study with 53 patients with type 1 diabetes mellitus. 30 patients with diabetic nephropathy including 19 patients with microalbuminuria (urinary albumin creatinine ratio: 30-300 mg/gm) and 11 patients with macroalbuminuria (urinary albumin creatinine ratio: >300 mg/gm). The remainder 23 patients had normal urinary albumin levels. In addition, there were 20 healthy age and sex matched children who served as control group. In all subjects we assessed urinary albumin, urinary creatinine and urinary albumin creatinine ratio and urinary Smad1 levels
Results: Urinary Smad1 levels and urinary Smad1 creatinine ratio show good sensitivity and specificity in detection of DN as compared to urinary albumin. The performance of SCR was better than urinary Smad1 with sensitivity and specificity of 100.0% and 96.0% for SCR, compared to sensitivity and specificity of 90.0% and 91.0% for urinary Smad1.
Conclusion: Urinary Smad1 is a promising new biomarker for detection of diabetic nephropathy in patients with type 1 diabetes mellitus with high sensitivity and specificity.