ORIGINAL ARTICLE Biomarkers of renal dysfunction among Ghanaian patients with type 2 diabetes mellitus- a cross-sectional study Brodrick Yeboah Amoah 1 & George Awuku Asare 1 & Francis Agyemang Yeboah 2 & Christian Obirikorang 2 & Bernice Asiedu 1 & Arab Omaima Mohammed 1 Received: 1 November 2017 /Accepted: 27 January 2018 # Research Society for Study of Diabetes in India 2018 Abstract Type 2 diabetes mellitus (T2DM) is a heterogeneous collection of disorders characterized by reduced insulin sensitivity and increased glucose output. The abnormal vascular architecture observed within the first few years of diabetes onset suggests that complications such as nephropathy develop earlier in affected individuals than is generally known. Prompt determination of decline in renal function among diabetics is therefore very crucial. In the present study, we evaluated circulating levels of adiponectin, neutrophil gelatinase-associated lipocalin (NGAL), asymmetric dimethyl arginine (ADMA), and endothelial nitric oxide synthase traffic inducer (NOSTRIN) as novel biomarkers of renal dysfunction. One hundred and eight Ghanaian patients with T2DM were recruited for this study. Biochemical and immunoassays were employed in measuring the levels of the biomarkers for all participants. Metabolic syndrome indices including body mass index (BMI), serum glucose, and uric acid levels were not found to be associated with adiponectin concentrations. Fifteen participants had normal estimated glomerular filtration rate (eGFR), 79 had a mildly reduced eGFR, and 24 had moderately reduced eGFR representing 12.8, 66.9, and 20.3%, respectively. Proteinuria correlated significantly with decreasing eGFR. Serum levels of adiponectin, ADMA, and NOSTRIN (p = 0.002; p = 0.001; p = 0.012, respectively) were, however, found to be independently associated with estimated glomerular filtration rate (eGFR) among the type 2 diabetics. We observed that elevated circulating levels of adiponectin, ADMA, and NOSTRIN could be important in characterizing early CKD stages among type 2 diabetics. Keywords Biomarkers . Type 2 diabetes . Complications . Nephropathy Introduction Scientific predictions indicate that by 2030, approximately 500 million adults will be burdened with diabetes. Presently, type 2 diabetes mellitus (T2DM) accounts for at least 90% of the overall recorded cases of diabetes [1, 2]. Some of the worsening records of its prevalence have been observed in African rural areas, advanced regions of Africa such as South Africa, and urban sub-Saharan Africa [6, 7]. The adop- tion of Western lifestyles—in addition to aging, population growth, urbanization, gene polymorphisms, physical inactivi- ty, and increasing prevalence of obesity—is central to the surge in the global incidence of the disease [10, 11]. The body’ s gluco-homeostasis systems ensure that regard- less of wide variations in demand of glucose, the concentra- tion of plasma glucose is kept within a narrow, physiological range [12]. In type 2 diabetic individuals, however, the glucose-monitoring and control mechanisms are compro- mised due to peripheral insulin resistance and pancreatic β- cell dysfunction attributable to glucotoxicity [ 13, 14]. Consequently, both macro and microvascular beds undergo endothelial dysfunction following a protracted period of hy- perglycemia. This leads to deleterious complications includ- ing cardiovascular diseases, vision loss, neuropathy, and renal dysfunction. In routine clinical practice, albuminuria and estimated glo- merular filtration rate (eGFR) are used as surrogate measures in the absence of a gold standard for assessing kidney func- tion. Among persons with T2DM, however, researchers have * Brodrick Yeboah Amoah abybrodrick@gmail.com 1 Chemical Pathology Unit, Medical Laboratory Sciences Department, SBAHS, CHS, University of Ghana, Accra, Ghana 2 Department of Molecular Medicine, School of Medical Sciences, KNUST, Kumasi, Ghana International Journal of Diabetes in Developing Countries https://doi.org/10.1007/s13410-018-0615-4