Progressive elevation of SIRT2 appears to reflect early renal injury in adults with type 2 diabetes mellitus (T2DM). Published in the Journal of Clinical Medicine, this study examined whether circulating SIRT2 can function as a complementary marker of diabetic nephropathy beyond urine albumin-to-creatinine ratio and estimated glomerular filtration rate.

The cross-sectional study enrolled 180 adults: 60 healthy controls, 60 individuals with T2DM without nephropathy, and 60 with T2DM and nephropathy. Serum SIRT2 concentrations were measured using a validated enzyme-linked immunosorbent assay. Statistical analyses included group comparisons, multinomial logistic regression, and receiver operating characteristic curve assessment.

Median serum SIRT2 levels increased across groups, rising from 6.13 ng/mL in healthy controls to 8.53 ng/mL in T2DM without nephropathy and to 33.19 ng/mL in T2DM with nephropathy (p < 0.001). Diagnostic accuracy for distinguishing diabetic nephropathy from healthy controls was good, with an area under the curve of 0.813. SIRT2 remained independently associated with diabetic nephropathy after adjustment for metabolic and renal covariates (adjusted odds ratio 1.22; 95% CI 1.11–1.35; p < 0.001).

These findings indicate that serum sirtuin 2 may complement traditional renal markers by reflecting injury pathways not captured by urine albumin-to-creatinine ratio or estimated glomerular filtration rate.