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Angiopoietin-2 (Angpt-2) has been implicated in the development and progression of DKD in adults. We aimed to explore the association of serum Angpt-2 levels with DKD in children and adolescents with type 1 diabetes mellitus (T1DM) of short duration (3\u20135\u00a0years) and to evaluate the predictive power of serum Angpt-2 in the early detection of DKD prior to the microalbuminuric phase. The current cross-sectional study included 90 children divided into three age and sex-matched groups based on urinary albumin-to-creatinine ratio (UACR): microalbuminuric diabetic group (<jats:italic>n<\/jats:italic>\u2009=\u200930), non-albuminuric diabetic group (<jats:italic>n<\/jats:italic>\u2009=\u200930), and control group (<jats:italic>n<\/jats:italic>\u2009=\u200930). All participants were subjected to anthropometric measurements, serum Angpt-2 and fasting lipid profile (total cholesterol, triglycerides, LDL-C, HDL-C, and Non-HDL-C) assessment. Glomerular filtration rate was estimated based on serum creatinine (eGFR-Cr). Higher serum Angpt-2 levels were detected in both diabetic groups compared to controls and in microalbuminuric compared to non-albuminuric diabetic group. There was no detected significant difference in eGFR-Cr values across the study groups. Serum Angpt-2 was positively correlated with triglycerides, LDL, Non-HDL-C, HbA1c, and UACR, while UACR, HbA1c, and Non-HDL-C were independent predictors for serum Angpt-2. Serum Angpt-2 at level of 137.4\u00a0ng\/L could discriminate between microalbuminuric and non-albuminuric diabetic groups with AUC\u2009=\u20090.960 and at level of 115.95\u00a0ng\/L could discriminate between the non-albuminuric diabetic group and controls with AUC\u2009=\u20090.976.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: Serum Angpt-2 is a promising potent biomarker for the detection of early stage of DKD in childhood T1DM before albuminuria emerges.<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td align=\"left\"><jats:bold>What is Known?<\/jats:bold>\u2022 <jats:italic>Urine albumin-to-creatinine ratio (UACR) and glomerular filtration rate (GFR) are the golden standard but late biomarkers for DKD.<\/jats:italic>\u2022 <jats:italic>Angiopoietin-2 has been implicated in the development and progression of DKD in adults with diabetes, but has not been explored in T1DM children with DKD.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\"><jats:bold>What is New?<\/jats:bold>\u2022 <jats:italic>Higher serum angiopoietin-2 was detected in diabetic groups compared to controls and in microalbuminuric compared to non-albuminuric group.<\/jats:italic>\u2022 <jats:italic>Angiopoietin-2 correlated positively with triglycerides, LDL, Non-HDL-C, HbA1c, and UACR.<\/jats:italic>\u2022 <jats:italic>Serum angiopoietin-2 is a promising early diagnostic biomarker for DKD in children with T1DM.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-024-05637-w","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T06:02:16Z","timestamp":1718604136000},"page":"3853-3862","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Serum angiopoietin-2: a promising biomarker for early diabetic kidney disease in children and adolescents with type 1 diabetes"],"prefix":"10.1007","volume":"183","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6783-9095","authenticated-orcid":false,"given":"Nanees Abdel-Badie","family":"Salem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa M.","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8568-0428","authenticated-orcid":false,"given":"Shimaa R.","family":"Hendawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf M.","family":"Abdelrahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1055-7131","authenticated-orcid":false,"given":"Ahmed M.","family":"El-Refaey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"issue":"3","key":"5637_CR1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1111\/dme.13124","volume":"34","author":"K Sandahl","year":"2017","unstructured":"Sandahl K, Nielsen LB, Svensson J, Johannesen J, Pociot F, Mortensen HB, Hougaard P, Broe R, Rasmussen ML, Grauslund J, Peto T, Olsen BS (2017) Increased mortality in a Danish cohort of young people with type 1 diabetes mellitus followed for 24 years. 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