Abstract
INTRODUCTION: Serum neutrophil gelatinase-associated lipocalin (sNGAL), a renal tubular marker, and neutrophil-to-lymphocyte ratio (NLR), a hematological inflammatory marker are two biomarkers that have recently received attention, because of their association with kidney disease. This study examined the diagnostic value sNGAL and NLR in type 2 diabetes mellitus (T2DM) patients with nephropathy. MATERIALS AND METHODS: In this hospital-based case-control research, 97 T2DM participants and 70 healthy subjects were included. Participants' information was documented using a structured questionnaire and patient case records. Venous blood was drawn from each participant and early morning midstream urine samples were collected for blood and urine measurements respectively. RESULTS: The prevalence of nephropathy among type 2 diabetics was 20.6%. sNGAL had a good performance (AUC = 0.793, p < 0.001) and NLR had a poor performance (AUC = 0.632, p = 0.082) for predicting diabetic nephropathy. An sNGAL cut-off of 8.87 µg/L had 80.0% sensitivity and NLR threshold of 2.34 had 60.0% sensitivity and 72.8% specificity. In the multivariate binary logistic model, sNGAL showed a modest independent association, (aOR 1.25, 95% CI: 0.71-2.21, p = 0.014). In contrast, NLR was not significantly associated with nephropathy in the adjusted model (NLR: aOR 1.16, 95% CI: 0.60-2.24, p = 0.663). CONCLUSIONS: Whiles sNGAL showed superiority and is recommended, NLR showed no significant group difference and poor, non-significant discrimination, indicating it is not a reliable standalone marker of diabetic nephropathy in this study.