Role of Serum Chromogranin A in Early Diagnosis of Diabetic Nephropathy

Abstract

Background: Kidney is the main site for the removal of Chromogranin A (CgA). Previous studies have found that patients with renal impairment displayed elevated concentrations of CgA in plasma and the CgA concentrations reflect deterioration of renal function. In this study, we aimed to estimate the serum CgA levels and to evaluate the role of serum CgA in early diagnosis of diabetic nephropathy (DN).Methods: A total of 219 patients with type 2 diabetes mellitus (T2DM) were included in this cross-sectional study. They were classified into normoalbuminuria (n = 121), microalbuminuria (n = 73), or macroalbuminuria (n = 25) groups based on their urine albumin to creatinine ratios (UACR). A control group consisted of 45 healthy subjects. The serum CgA levels were measured by ELISA and other key parameters were assayed.Results: The serum CgA levels were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied subgroups regarding CgA was found (P<0.05). Levels of serum CgA were increasing gradually with the degree of DN (P<0.001). Serum CgA levels were moderate intensity positively correlated with UACR (P<0.001). A cut-off level of 3.46 ng/ml CgA showed 69.86% sensitivity and 66.12% specificity to detect DN in early stage.Conclusions: Levels of serum CgA increased gradually with the degree of DN, and can be used as a biomarker in early detection of DN.