A Study on Evaluation of Spot Urine Microalbumin and Protein Creatinine Ratio in Newly Diagnosed Type 2 Diabetic Patients

Abstract

Background

Type 2 Diabetes Mellitus (T2DM) is a rapidly increasing global health problem associated with significant microvascular complications, particularly diabetic nephropathy. Early detection of renal involvement is essential to prevent progression to chronic kidney disease. Microalbuminuria and protein-creatinine ratio (PCR) in spot urine samples have emerged as simple and non-invasive biomarkers for early detection. However, their comparative diagnostic utility in newly diagnosed T2DM patients remains an area of ongoing research.

Methods

This case-control study was conducted in the Department of Biochemistry, Malwanchal University, Indore. A total of 636 participants were included, comprising 318 newly diagnosed T2DM patients (cases) and 318 non-diabetic individuals (controls). Clinical, anthropometric, biochemical, and lifestyle-related data were collected. Spot urine samples were analyzed for microalbuminuria and protein-creatinine ratio (PCR), while blood samples were evaluated for fasting blood sugar and HbA1c. Lipid profile and urinary parameters were also assessed. Statistical analysis was performed using appropriate tests, with p < 0.05 considered statistically significant.

Results

Diabetic patients demonstrated significantly higher fasting blood sugar (264.6 ± 81.58 mg/dL vs 158.6 ± 52.38 mg/dL) and HbA1c levels (10.2 ± 2.01% vs 8.42 ± 2.07%) compared to controls (p < 0.001). Lipid profile abnormalities, including elevated triglycerides, LDL, and VLDL, along with reduced HDL levels, were also statistically significant (p < 0.001). The protein-creatinine ratio was significantly higher in cases (2.46 ± 1.39) compared to controls (1.82 ± 0.99) (t = 6.72, p < 0.001), indicating early renal involvement. In contrast, microalbuminuria did not show a statistically significant difference between groups (p = 0.07). Urinary findings such as glucosuria, ketonuria, hematuria, and increased urinary sediments were more prevalent in diabetic patients. Strong correlations were observed between glycemic parameters and lipid profile in the case group.

Conclusion

The study concludes that protein-creatinine ratio (PCR) is a more sensitive and reliable marker than microalbuminuria for early detection of renal impairment in newly diagnosed T2DM patients. Spot urine analysis provides a simple, non-invasive, and cost-effective screening tool suitable for routine clinical practice. Early identification of renal dysfunction, along with comprehensive metabolic control, can significantly reduce the progression of diabetic nephropathy and improve patient outcomes.