Abstract

Background: Diabetic nephropathy (DN) is a serious complication in diabetes and now it has become the most common cause of end-stage renal disease (ESRD). Development of diabetic nephropathy is characterized by a thickening of the glomerular basement membrane and expansion of extracellular matrix proteins in the mesangial and tubulointerstitial areas, followed ultimately by progression to glomerular sclerosis and tubulointerstitial atrophy and fibrosis associated with renal dysfunction. Several growth factors, signaling pathways, along with hyperglycemia affect ECM synthesis and turnover in DN.

Objective: The aim of this study was to evaluate the significance of plasma and urinary matrix metalloproteinase-9 (MMP-9) in type 2 diabetic patients with microalbuminuria.

Materials and Methods: Fifty type 2 diabetic patients with more than 5 year diabetic duration in the age group of 35–60 years were selected for this study and 25 age-matched healthy individuals were selected as a control group. Plasma and urinary levels of MMP-9 were assessed by ELISA method and microalbumin by turbilatex method.

Results: The plasma and urinary MMP-9 levels are significantly elevated in type 2 DM with microalbuminuria compared to normoalbuminuric type 2DM and also there is significant elevation observed in normoalbuminuric type 2 DM compared to controls.

Conclusion: Plasma and urinary MMP-9 might be useful to detect early stages of nephropathy in T2DM patients. Hence, measurement of plasma and urinary MMP-9 could be useful diagnostic markers for the assessment of renal changes in type 2 diabetic patients even before the appearance of microalbuminuria.

Key words: Diabetic nephropathy, matrix metalloproteinase-9 (MMP-9), microalbuminuria