{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T20:00:35Z","timestamp":1784836835305,"version":"3.55.0"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BSMMU grant committee"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Conventional biomarkers, such as the urinary albumin-to-creatinine ratio (uACR), detect diabetic nephropathy (DN) late in its course and may miss early podocyte injury. Urinary podocalyxin (u-PDX), a sialylated glycoprotein shed from podocytes, may offer an earlier means of detection.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a cross-sectional analytical study at Bangabandhu Sheikh Mujib Medical University between March 2023 and August 2024. Eighty-eight adults were enrolled: 59 participants with type 2 diabetes mellitus (T2DM) and 29 healthy controls. Participants with diabetes were stratified into normoalbuminuric (n\u2009=\u200929), microalbuminuric (n\u2009=\u200915), and macroalbuminuric (n\u2009=\u200915) subgroups based on uACR. Clinical variables and biochemical indices were recorded. u-PDX concentrations were measured using ELISA, and associations with uACR and eGFR were analyzed using Kendall\u2019s tau-b and Pearson\u2019s correlation coefficients. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves with bootstrap internal validation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among participants with diabetes, u-PDX levels increased progressively across normo-, micro-, and macroalbuminuric groups (p\u2009<\u20090.001). u-PDX correlated positively with fasting blood glucose, post-glucose plasma glucose, HbA1c, serum creatinine, serum urea, and uACR, with the strongest correlation for uACR (r\u2009=\u20090.79, p\u2009<\u20090.001), and inversely with serum albumin (r\u2009= \u22120.62, p\u2009<\u20090.001) and eGFR (r\u2009= \u22120.51, p\u2009<\u20090.001). In pairwise ROC analysis, a u-PDX cutoff of 0.80 ng\/mL discriminated healthy controls from diabetic patients without albuminuria (sensitivity 100.0%, specificity 96.4%); 1.60 ng\/mL discriminated diabetic patients without albuminuria from those with microalbuminuria (86.7%, 93.1%); and 5.51 ng\/mL discriminated microalbuminuric from macroalbuminuric patients (86.7%, 93.3%). For overall discrimination of albuminuria-defined DN among diabetic patients, the optimal u-PDX cutoff was 2.92 ng\/mL (AUC 0.96, 95% CI 0.90\u20131.00).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Urinary podocalyxin is a sensitive early biomarker of diabetic nephropathy, rising before overt albuminuria and correlating with albuminuria severity and declining eGFR. However, longitudinal validation is required before u-PDX can be recommended for routine screening in adults with T2DM.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0347975","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:00:25Z","timestamp":1784833225000},"page":"e0347975","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary podocalyxin as an early biomarker for diabetic nephropathy"],"prefix":"10.1371","volume":"21","author":[{"given":"Md. Sabbir","family":"Hossain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamsia Tasnim","family":"Dwipi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazma","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled Mahbub","family":"Murshed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5221-0021","authenticated-orcid":true,"given":"Kazi Ali","family":"Aftab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8523-0288","authenticated-orcid":true,"given":"Abdullah","family":"Al Mahdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Mojibul","family":"Hoque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Jobayer Hossain","family":"Taraq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Zakir","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8395-0898","authenticated-orcid":true,"given":"Md. 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