Correlation Between Chemerin Levels and Diagnosis of Diabetic Nephropathy: A Case-Control Study

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Attia Elsayed F.M.; Salem S.M.; Attia Elbadry M.M.; Omar A.; Alwaseef M.A.E.; Mohamed E.S.; Boshra M.S.; Ismail H.A.M.; Zidan M.H.S.; Ali O.S.H.; Hamed O.A.E.; Abd El Fattah M.Y.; Rashad D.F.; Rashed R.M.I.; Kayed A.A.A.; Azel L.H.; Saleh R.H.A.A.; Moneer A.H.; Mahrose H.K.A.; Da A.

Journal: Clinica Terapeutica

Publisher: Societa Editrice Universo

Publication Date: 2026

Volume / Issue: Volume 177 / Issue 3

Pages: 554–562

ISSN: 99074

DOI: 10.7417/CT.2026.2041

Scopus: View on Scopus

PubMed: 42047143

Document Type: Article

Authors and Affiliations

Attia Elsayed F.M., Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt; Salem S.M., Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt; Attia Elbadry M.M., Family Medicine Department, Faculty of Medicine, Zagazig University, Egypt; Omar A., Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Alwaseef M.A.E., Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Mohamed E.S., Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Boshra M.S., Department of Medical Biochemistry and Molecular biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Ismail H.A.M., Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt; Zidan M.H.S., Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt; Ali O.S.H., Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Hamed O.A.E., Department of Clinical Pathology, General Organization for Teaching hospitals and Institutes, National Heart Institute, Cairo, Egypt; Abd El Fattah M.Y., Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; Rashad D.F., Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; Rashed R.M.I., Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; Kayed A.A.A., Nephrology Department, Al Mahd General Hospital, Ministry of Health, Saudi Arabia; Azel L.H., Endocrinology and Metabolism Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; Saleh R.H.A.A., Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; Moneer A.H., Faculty of Medicine, Department of Ophthalmology, October 6 University, Egypt; Mahrose H.K.A., Clinical Chemistry Department, Theodor Bilharz Research Institute, Cairo, Egypt; Da A., Clinical and Chemical Pathology Department, Faculty of Medicine, Zagazig University, Egypt

Abstract

Background. Diabetic nephropathy (DN) and diabetic retinopathy (DR) are major microvascular complications of type 2 diabetes mellitus (T2DM), sharing common inflammatory and metabolic pathways. Chemerin, an adipokine involved in inflammation and endothelial dysfunction, may serve as an early biomarker for DN. Objective. To evaluate serum Chemerin levels in type 2 diabetic patients across different stages of albuminuria and to explore its correlation with anthropometric indices and inflammatory markers. Methods. This case-control study included patients with T2DM categorized according to urinary albumin excretion into normoalbuminuria, microalbuminuria, and macroalbuminuria groups. Serum Chemerin levels were measured using ELISA. All participants underwent comprehensive fundus examination after pupillary dilation, and diabetic retinopathy was graded according to standard clinical criteria. Clinical, biochemical, and metabolic parameters were recorded and correlated with albuminuria stages and retinal findings. Results. Serum Chemerin levels were significantly elevated in diabetic patients with micro- and macro-albuminuria compared with normo-albuminuric patients and healthy controls. Median Chemerin levels increased progressively from 721 ng/mL in the normo-albuminuric group to 1367 ng/mL in the micro-albuminuria group and 2793 ng/mL in the macro-albuminuria group (p < 0.001). Similarly, inflammatory markers demonstrated a stepwise increase with worsening albuminuria; median IL-6 levels rose from 6.34 pg/mL in normo-albuminuric patients to 7.34 pg/mL and 9.6 pg/mL in the micro- and macro-albuminuria groups, respectively, while TNF-α increased from 94 pg/mL to 124 pg/mL and 296 pg/mL across the same groups (p < 0.001). Insulin resistance indices also increased significantly, with median HOMA-IR values rising from 2.45 in normo-albuminuric patients to 3.29 and 4.68 in the micro- and macro-albuminuria groups (p < 0.001). Serum Chemerin showed strong positive correlations with albuminuria (r = 0.85), HOMA-IR (r = 0.85), IL-6 (r = 0.873), and TNF-α (r = 0.813), while demonstrating negative correlations with eGFR and serum albumin. Additionally, the prevalence of diabetic retinopathy increased significantly across albuminuria stages, reaching 82.6% in the macro-albuminuria group (p = 0.001). Conclusion. Serum Chemerin is significantly elevated in T2DM patients with albuminuria and correlates with both inflammatory markers and retinal microvascular changes, suggesting its potential utility as an adjunct biomarker for diabetic nephropathy and systemic microvascular complications. Fundus examination findings reinforce the parallel progression of diabetic nephropathy and retinopathy, highlighting shared pathogenic mechanisms. Copyright © 2026 Società Editrice Universo (SEU), Roma, Italy. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords

Albuminuria; Case-control study; Chemerin; Diabetic nephropathy; Diabetic retinopathy; Inflammatory markers; Aged; Biomarkers; Case-Control Studies; Chemokines; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Female; Humans; Intercellular Signaling Peptides and Proteins; Male; Middle Aged; biological marker; interleukin 6; tumor necrosis factor; chemokine; RARRES2 protein, human; adult; anthropometry; Article; biochemistry; case control study; clinical assessment; clinical evaluation; controlled study; disease association; disease exacerbation; HOMA index; human; insulin resistance; macroalbuminuria; major clinical study; microalbuminuria; non insulin dependent diabetes mellitus; protein blood level; urinary excretion; blood; complication; diagnosis; etiology

Citation Information

Scopus Citations: 0

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