Estimation of Angiopoietin-Like Protein 3 and Fibroblast Growth Factor-23 Levels as Highly Sensitive Early Prognostic Factors in Iraqi Diabetics with Nephropathy

Abstract

     There has been significant interest in the field of diabetes complications, particularly diabetic nephropathy. This includes the use of biochemical factors as early diagnostic markers to prevent the deterioration of patients’ health. Accordingly, the current study aimed to identify the levels of angiopoietin-like protein-3 (ANGPTL3) and fibroblast growth factor-23 (FGF23) in Iraqi patients with diabetic nephropathy, which may serve as early indicators for the diagnosis of the disease. The study included 143 individuals aged 35-65 years who were visiting the Medical City of Baghdad Teaching Hospital from August to December 2024. The patients were divided into three groups based on the ACR criteria. The first group was the normoalbuminuria group (ACR<30 mg/g, 35 patients), and the second was the microalbuminuria group (ACR =30-300 mg/g, 33 patients). The third group was the macroalbuminuria group (ACR > 300 mg/g, 35 patients). The fourth group, which included 40 healthy individuals, represented the control group. The lipid profile, urea, and creatinine levels were measured using spectrophotometric methods. ELISA was used to measure ANGPL3 and FGF23 levels. The results showed a significant increase in both ANGPTL3 and FGF23 levels between the patient and healthy groups. The results of the lipid profile, urea, HbA1C, and creatinine were consistent with the results of ANGPTL3 and FGF23, which were found to be significantly increased in the patient groups compared with the control group. Also, the ROC results confirmed that these factors are perfect or excellent for this case. In conclusion, depending on the current outcomes, with ROC results, both ANGPTL3 and FGF23 appear to possess high detection sensitivity toward the targeted case. It may be used as an excellent factor for the early prediction of diabetic nephropathy development.