Serum Adiponectin as a Diagnostic Marker of Early Renal Dysfunction in Patients with Hypertension and Type 2 Diabetes

Abstract

Background: The coexistence of type 2 diabetes mellitus (T2DM) and hypertension markedly increases the risk of renal complications. This study evaluated the relationship between adiponectin and the urinary albumin-to-creatinine ratio (UACR) and examined the diagnostic value of the UACR/adiponectin ratio for early detection of kidney dysfunction. Methods: In this cross-sectional study, 90 participants (40 to 80 years) were divided into four groups: hypertension (n=24), T2DM (n=24), combined T2DM with hypertension (n=24), and healthy controls (n=18). Key metabolic and renal markers were assessed. Serum adiponectin was measured by ELISA, UACR and CRP were determined, and renal function was evaluated using eGFR (CKD-EPI equation). Data were analyzed using SPSS version 27. Results: Urinary albumin-to-creatinine ratio (UACR) showed a statistically significant difference among the studied groups (P=0.006), with higher levels observed in diabetic patients. Moreover, UACR was independently associated with renal dysfunction (OR=1.415, P=0.002). In contrast, adiponectin levels did not demonstrate statistically significant differences between groups or according to sex. However, ROC curve analysis indicated a moderate diagnostic performance for adiponectin (AUC=0.674), with a cutoff value >17.46 yielding a sensitivity of 58.82% and a specificity of 78.18%. Notably, the UACR/adiponectin ratio exhibited excellent diagnostic performance (AUC=0.934). At a cutoff value >1.67, it demonstrated a sensitivity of 86% and specificity of 90%, with an overall accuracy of 90.28%. Conclusion: The UACR/adiponectin ratio outperformed adiponectin alone and may serve as a reliable combined biomarker for early detection of renal dysfunction in patients with metabolic disorders.