Evaluation of Serum Soluble CD36 Levels in the Clinical Progression of Diabetic Nephropathy

Diabetic nephropathy (DN) is one of the major contributors to end stage kidney disease globally. Reliable biomarkers for early diagnosis of DN still exists as a major challenge. Serum soluble CD36 (sCD36) involved in lipid metabolism and oxidative stress has been identified as a likely biomarker of DN. Herein, we assess the relationship between sCD36 and clinical worsening of DN, to determine its potential diagnostic value.

A case- control study involving 160 participants, categorized into four groups was conducted i.e., healthy individuals, diabetics with normo-albuminuria, microalbuminuria, and macroalbuminuria (n = 40).Demographic variables and biochemical parameters were compared. The concentrations of sCD36 in serum samples were determined, as well as correlation analysis between sCD36, fasting plasma glucose (FPG), HbA1c, urine albumin creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were performed. The diagnostic performance of sCD36 was determined using receiver operating characteristic (ROC) curve.

Serum sCD36 levels rose progressively from 9.97 ng/mL in the control group to 12.13 ng/mL in the macroalbuminuria group, p < 0.001. Patients with higher sCD36 levels also had higher fasting plasma glucose, HbA1C, and UACR with a lower eGFR. The ROC analysis of sCD36 gave an AUC of 0.908, showing excellent diagnostic capability of the model. The optimal cut-off value of 10.6 ng/mL yielded 87.5 % sensitivity and 80.83% specificity for detecting advanced DN.

Increased serum sCD36 levels correlates directly to DN progression, hence being a promising candidate biomarker for diagnosis and prognosis. The possible direct application of sCD36 into clinical practice might help improve DN management and treatment.