Lipidomic Profiling of Plasma Phospholipids in Type 2 Diabetes Patients with and Without Nephropathy in Kaduna State

Diabetic nephropathy is a leading cause of chronic kidney disease in Nigeria, and identifying lipidomic signatures that distinguish type 2 diabetic patients with nephropathy from those without renal complications may advance understanding of lipid-mediated nephropathic mechanisms and biomarker discovery. This study performs lipidomic profiling of plasma phospholipids in type 2 diabetes patients with and without nephropathy in Kaduna State. Sixty type 2 diabetic patients with confirmed nephropathy (eGFR below 60 mL/min/1.73m2 and microalbuminuria above 30 mg/g creatinine), sixty diabetic patients without nephropathy, and forty healthy controls from Ahmadu Bello University Teaching Hospital, Zaria, were enrolled. Plasma phospholipids were extracted by the Bligh-Dyer method and profiled by ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. Multivariate statistical analysis including principal component analysis and partial least squares discriminant analysis was applied for group discrimination. Results identified 47 differentially abundant phospholipid species across the three groups, with phosphatidylcholines and lysophosphatidylcholines showing the most significant alterations in nephropathy. Specifically, selected lysophosphatidylcholine species were significantly depleted in nephropathy patients compared to both diabetic controls and healthy controls, while several phosphatidylethanolamine species were elevated. Pathway analysis implicates altered phospholipase A2 activity and disrupted choline glycerophospholipid remodelling in nephropathic progression. A four-lipid discriminant panel achieved 83 percent accuracy in distinguishing nephropathy from non-nephropathy diabetic patients. These lipidomic signatures represent candidate biomarkers for early nephropathy risk stratification. Keywords: lipidomics, diabetic nephropathy, phospholipids, type 2 diabetes, Kaduna State.