Assessment of IGFBP-1 and FABP-4 Levels in Iraqi Diabetic Patients with Nephropathy as Potential Biomarkers for the Disease Progression

Diabetes mellitus is a major cause of kidney failure and diabetic nephropathy, making early detection of renal complications an important clinical concern. This study aimed to evaluate the metabolic regulators insulin-like growth factor-binding protein-1 (IGFBP-1) and fatty acid-binding protein-4 (FABP-4) as potential biomarkers for the early detection and monitoring of diabetic nephropathy progression. The study included 75 diabetic patients aged 35–65 years who attended Medical City between February and September 2023. Patients were divided into three groups based on the albumin-to-creatinine ratio: normoalbuminuria, microalbuminuria, and macroalbuminuria, with 25 patients in each group. A control group consisted of 50 healthy individuals. Serum urea, fasting blood sugar, lipid profile, uric acid, and creatinine were measured using spectrophotometric methods, while IGFBP-1 and FABP-4 levels were determined using the ELISA technique. Estimated glomerular filtration rate (eGFR) was also calculated. The results showed significantly higher IGFBP-1 and FABP-4 levels in all diabetic nephropathy groups than in healthy controls (p = 0.0001). ROC analysis demonstrated excellent diagnostic performance of IGFBP-1 in microalbuminuria (AUC = 0.995) and FABP-4 in macroalbuminuria (AUC = 0.997). Urea, creatinine, uric acid, and lipid parameters, except HDL, blood glucose, and HbA1c, were also significantly elevated in patients, whereas eGFR was significantly reduced (p = 0.0001). In conclusion, IGFBP-1 and FABP-4 showed high diagnostic sensitivity and may serve as potential biomarkers for the early detection and monitoring of diabetic nephropathy progression in Iraqi patients.