DOI: 10.32322/jhsm.1973675 ISSN: 2636-8579

Serum arginase and nitric oxide levels in type 2 diabetes with and without diabetic nephropathy: associations and diagnostic performance

Selman Gencer, Hasan Şimşek
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Aims: This study aimed to compare serum arginase and nitric oxide (NO) levels in patients with type 2 diabetes mellitus (T2DM) with and without diabetic nephropathy (DN), evaluate their associations with renal function, and assess their diagnostic performance for DN.Methods: This retrospective case-control study included 89 patients with T2DM, comprising 45 patients with DN and 44 without nephropathy. Serum arginase and NO concentrations were measured using ELISA. Group comparisons were performed according to data distribution, and Benjamini-Hochberg false discovery rate correction was applied to secondary laboratory variables. Associations with creatinine, eGFR, and microalbuminuria were evaluated using age- and gender-adjusted partial Spearman correlations. Multivariable linear and logistic regression analyses were performed, and diagnostic performance was assessed using receiver operating characteristic analysis.Results: Serum arginase levels were higher in patients with DN than in those without nephropathy (49.92±14.28 vs. 43.67±12.35 pg/ml; p=0.030), whereas NO levels did not differ significantly [0.757 (0.670-0.952) vs. 0.741 (0.584-0.906) µmol/L; p=0.433]. After adjustment for age and gender, the between-group difference in arginase was attenuated (β=6.25, 95% CI: -0.13-12.64; p=0.055). Arginase remained modestly associated with DN in logistic regression (OR=1.049, 95% CI: 1.002-1.098; p=0.040). Neither biomarker showed significant adjusted correlations with renal parameters. Diagnostic discrimination was limited for arginase (AUC=0.610) and NO (AUC=0.548).Conclusion: Serum arginase may be modestly associated with DN, but neither arginase nor NO appears suitable as a stand-alone diagnostic biomarker.

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