Role of Nephropathological Factors with Fibrinogen in the Progression of Human Diabetic Nephropathy in the Pakistani Population

Introduction: Fibrinogen is synthesized in the liver and is a marker of acute-phase inflammation. It is essential for regulating the inflammatory response by attaching to receptors on the surfaces of many cells and is involved in the pathogenesis of kidney diseases. The objective of this investigation is to identify the role of fibrinogen in the progression of diabetic nephropathy in the Pakistani population. Method: This study was based on an analytical comparative research. A total number of 1152 subjects were enrolled from selected cities of Pakistan (Islamabad, Lahore, Multan, Gujranwala, Karachi, and Gharro). The subjects were classified into the Control group (n=384), the Diabetes Mellitus group (DM) (n=384), and the Diabetic Nephropathy group (DN) (n=384) based on glycemic condition and glomerular filtration rate. The serum fibrinogen level was assessed using an enzyme-linked immunosorbent test (ELISA). The expression profile of fibrinogen was determined using real-time PCR. Result: The highly significant difference in serum fibrinogen levels was found among the control, DM, and DN groups. The fibrinogen expression was increased by more than ̴ 12.03 n-fold in the control group as compared to the DM group (n-fold = ̴ 4.78) and the DN group (n-fold = ̴ 5.42). When the correlation between the serum fibrinogen and blood sugar was analyzed, the DN (r=-0.145) had an inverse and highly significant relationship. The fibrinogen expression has a direct and significant correlation with blood urea (r=0.166). The stepwise linear regression analysis concluded that expression of fibrinogen is an important determinant of kidney function in the DM group. Creatinine, age, and blood sugar were important determinants in the DN group. Discussion: The cities of Pakistan, i.e, Lahore, Gujranwala, Multan, Islamabad, Karachi, and Gharro, exhibited significant variations in expression of Fibrinogen. This highlights a notable difference in the genetic profile across these regions of Pakistan. Conclusion: The results of our study indicate a complex relationship between levels of fibrinogen and diabetic nephropathy. The findings suggest that in diabetic renal disease, fibrinogen could have an early role, whereas with the progression of nephropathy, its significance diminishes. Further studies are required to explain the underlying mechanisms involved, relating this as a potential target for therapy in diabetic kidney disease.