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Abstract <p>This study investigated the association of transforming growth factor-beta 1 (TGF-β1), cancer antigen 15 − 3 (CA15-3), and serum retinol levels with disease progression in patients with type 2 diabetes mellitus (T2DM) presenting with different stages of diabetic nephropathy (DN). A total of 150 individuals aged 36–70 years were enrolled and divided into three groups (<i>n</i> = 50 each): T2DM without nephropathy, early diabetic nephropathy, and advanced diabetic nephropathy. Renal function markers, including glomerular filtration rate (GFR), creatinine, urea, uric acid, albumin-to-creatinine ratio (ACR), and electrolyte levels, were measured using standard biochemical methods. Serum TGF-β1, CA15-3, and retinol concentrations were determined using enzyme-linked immunosorbent assay (ELISA).</p> <p>TGF-β1 levels were significantly increased in patients with advanced DN (995.47 ± 351.42 pg/mL) and early DN (558 ± 250.14 pg/mL), compared with T2DM patients without DN (405.12 ± 77.14 pg/mL) (<i>P</i> ≤ 0.05). while CA15-3 levels were significantly increased in T2DM patients without DN (2.15 ± 16.7 ng/mL) and patients with advanced DN (0.75 ± 12.7 ng/mL), compared with early DN (0.68 ± 11.25 ng/mL) (<i>P</i> ≤ 0.05) On the other hand, serum retinol levels went down as the disease got worse, measuring (0.70 ± 0.30&#xa0;mg/L) in T2DM without DN, (0.61 ± 0.20&#xa0;mg/L) in early DN, and (0.50 ± 0.04&#xa0;mg/L) in advanced DN (<i>P</i> ≤ 0.05). The glomerular filtration charge (GFR) was significantly decreased in the Advanced Diabetic Nephropathy group (40.80 ± 18.20&#xa0;ml/min/1.73&#xa0;m²) in comparison to the Early institution (58.95 ± 20.4&#xa0;ml/min/1.73&#xa0;m²) and the T2DM without DN group (90.32 ± 9.57&#xa0;ml/min/1.73&#xa0;m²). Additionally, kidney function measurements like creatinine, urea, and uric acid showed much elevated levels as the stages of diabetic nephropathy progressed.</p> <p>These findings suggest that elevated TGF-β1 levels are strongly associated with the progression of diabetic nephropathy and may serve as a potential biomarker of renal fibrotic activity, while decreased serum retinol may reflect impaired antioxidant status during disease progression. Monitoring these biomarkers may improve early detection and risk stratification of diabetic nephropathy in patients with T2DM.</p> Lay Summary <p>With remarkable correlations to renal characteristic indicators such as GFR, creatinine, and urea in both early and advanced levels of DN, TGF-β1 in particular has emerged as a potent marker of renal impairment.</p> Graphical Abstract <p></p>

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Transforming Growth Factor Beta 1, Ca15-3, and Serum Retinol Levels as Biomarkers of Disease Progression in Diabetic Nephropathy Associated with Type 2 Diabetes Mellitus

  • 期刊论文

  • 发表日期：

    2026年4月14日

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  • Shaimaa Imad Ali,
  • Qutban Ibrahim Hasan,
  • Khalida Samawia,
  • Layla Imad Ali,
  • Morenike Olufunmilayo Akpo,
  • Great Iruoghene Edo,
  • Huzaifa Umar

摘要

Abstract

This study investigated the association of transforming growth factor-beta 1 (TGF-β1), cancer antigen 15 − 3 (CA15-3), and serum retinol levels with disease progression in patients with type 2 diabetes mellitus (T2DM) presenting with different stages of diabetic nephropathy (DN). A total of 150 individuals aged 36–70 years were enrolled and divided into three groups (n = 50 each): T2DM without nephropathy, early diabetic nephropathy, and advanced diabetic nephropathy. Renal function markers, including glomerular filtration rate (GFR), creatinine, urea, uric acid, albumin-to-creatinine ratio (ACR), and electrolyte levels, were measured using standard biochemical methods. Serum TGF-β1, CA15-3, and retinol concentrations were determined using enzyme-linked immunosorbent assay (ELISA).

TGF-β1 levels were significantly increased in patients with advanced DN (995.47 ± 351.42 pg/mL) and early DN (558 ± 250.14 pg/mL), compared with T2DM patients without DN (405.12 ± 77.14 pg/mL) (P ≤ 0.05). while CA15-3 levels were significantly increased in T2DM patients without DN (2.15 ± 16.7 ng/mL) and patients with advanced DN (0.75 ± 12.7 ng/mL), compared with early DN (0.68 ± 11.25 ng/mL) (P ≤ 0.05) On the other hand, serum retinol levels went down as the disease got worse, measuring (0.70 ± 0.30 mg/L) in T2DM without DN, (0.61 ± 0.20 mg/L) in early DN, and (0.50 ± 0.04 mg/L) in advanced DN (P ≤ 0.05). The glomerular filtration charge (GFR) was significantly decreased in the Advanced Diabetic Nephropathy group (40.80 ± 18.20 ml/min/1.73 m²) in comparison to the Early institution (58.95 ± 20.4 ml/min/1.73 m²) and the T2DM without DN group (90.32 ± 9.57 ml/min/1.73 m²). Additionally, kidney function measurements like creatinine, urea, and uric acid showed much elevated levels as the stages of diabetic nephropathy progressed.

These findings suggest that elevated TGF-β1 levels are strongly associated with the progression of diabetic nephropathy and may serve as a potential biomarker of renal fibrotic activity, while decreased serum retinol may reflect impaired antioxidant status during disease progression. Monitoring these biomarkers may improve early detection and risk stratification of diabetic nephropathy in patients with T2DM.

Lay Summary

With remarkable correlations to renal characteristic indicators such as GFR, creatinine, and urea in both early and advanced levels of DN, TGF-β1 in particular has emerged as a potent marker of renal impairment.

Graphical Abstract