Evaluation of urinary N-acetyl-beta-D-glucosaminidase as a marker of early renal damage in patients with type 2 diabetes mellitus

被引:22
作者
Bouvet, Beatriz R. [1 ]
Paparella, Cecilia V. [1 ]
Arriaga, Sandra M. M. [1 ]
Monje, Adriana L. [2 ]
Amarilla, Ana M. [1 ]
Almara, Adriana M. [1 ]
机构
[1] Univ Nacl Rosario, Fac Ciencias Bioquim & Farmaceut, Dept Clin Biochem, RA-2000 Rosario, Santa Fe, Argentina
[2] Univ Nacl Rosario, Fac Ciencias Med, Serv Nephrol, RA-2000 Rosario, Santa Fe, Argentina
关键词
Diabetic nephropathy; type 2 diabetes mellitus; tubular dysfunction; N-acetyl-beta-D-glucosaminidase; microalbuminuria; TUBULAR INJURY; KIDNEY-DISEASE; MICROALBUMINURIA; PROTEINURIA;
D O I
10.1590/0004-2730000003010
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To evaluate the clinical usefulness of urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion for the detection of early tubular damage in type 2 diabetes mellitus (T2DM). Subjects and methods: Thirty six patients with T2DM were divided into two groups based on urinary albumin to creatinine ratio (ACR): normoalbuminuria (ACR < 30 mg/g; n = 19) and microalbuminuria (ACR = 30-300 mg/g; n = 17). The following parameters were determined in both groups: urinary NAG and albumin, serum and urine creatinine, fasting plasma glucose and glycated hemoglobin (HbA(1c)). Results: Urinary NAG levels [Units/g creatinine; median (range)] were significantly increased in microalbuminuria group [17.0 (5.9 - 23.3)] compared to normoalbuminuria group [4.4 (1.5 - 9.2)] (P < 0.001). No differences between groups were observed in fasting glucose, HbA(1c), serum creatinine levels and estimated glomerular filtration rates (eGFR). Urinary NAG positively correlated with ACR (r = 0.628; p < 0.0001), while no significant association was observed between NAG and glycemia, HbA(1c), serum creatinine and eGFR. Conclusions: The increase of urinary NAG at the microalbuminuria stage of diabetic nephropathy (DN) suggests that tubular dysfunction is already present in this period. The significant positive association between urinary NAG excretion and ACR indicates the possible clinical application of urinary NAG as a complementary marker for early detection of DN in T2DM.
引用
收藏
页码:798 / 801
页数:4
相关论文
共 17 条
[1]   How does proteinuria cause progressive renal damage? [J].
Abbate, Mauro ;
Zoja, Carla ;
Remuzzi, Giuseppe .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2006, 17 (11) :2974-2984
[2]  
Amer Diabet Assoc, 2011, DIABETES CARE, V34, pS11, DOI [10.2337/dc10-S062, 10.2337/dc14-S081, 10.2337/dc11-S011, 10.2337/dc13-S011, 10.2337/dc13-S067, 10.2337/dc12-s064, 10.2337/dc11-S062, 10.2337/dc10-S011, 10.2337/dc12-s011]
[3]   Urinary N-acetyl B glucosaminidase as an earlier marker of diabetic nephropathy and influence of low-dose perindopril/indapamide combination [J].
Basturk, T ;
Altuntas, Y ;
Kurklu, A ;
Aydin, L ;
Eren, N ;
Unsal, A .
RENAL FAILURE, 2006, 28 (02) :125-128
[4]   Disease-dependent mechanisms of albuminuria [J].
Comper, Wayne D. ;
Hilliard, Lucinda M. ;
Nikolic-Paterson, David J. ;
Russo, Leileata M. .
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY, 2008, 295 (06) :F1589-F1600
[5]  
Farvid M. S., 2007, SMJ Singapore Medical Journal, V48, P840
[6]   Possible relationship between adiponectin and renal tubular injury in diabetic nephropathy [J].
Fujita, Hlroki ;
Morii, Tsukasa ;
Koshimura, Jun ;
Ishikawa, Motoko ;
Kato, Masako ;
Miura, Takeshi ;
Sasaki, Hiroshi ;
Narita, Takuma ;
Ito, Seiki ;
Kakei, Masafumi .
ENDOCRINE JOURNAL, 2006, 53 (06) :745-752
[7]   RENAL TUBULAR PROTEINURIA AND MICROALBUMINURIA IN DIABETIC-PATIENTS [J].
GIBB, DM ;
TOMLINSON, PA ;
DALTON, NR ;
TURNER, C ;
SHAH, V ;
BARRATT, TM .
ARCHIVES OF DISEASE IN CHILDHOOD, 1989, 64 (01) :129-134
[8]   The tubulointerstitium in progressive diabetic kidney disease: More than an aftermath of glomerular injury? [J].
Gilbert, RE ;
Cooper, ME .
KIDNEY INTERNATIONAL, 1999, 56 (05) :1627-1637
[9]   Markers of diabetic nephropathy [J].
Hong, CY ;
Chia, KS .
JOURNAL OF DIABETES AND ITS COMPLICATIONS, 1998, 12 (01) :43-60
[10]   ENZYMURIA IN NON-INSULIN-DEPENDENT DIABETIC-PATIENTS - SIGNS OF TUBULAR CELL DYSFUNCTION [J].
IKENAGA, H ;
SUZUKI, H ;
ISHII, N ;
ITOH, H ;
SARUTA, T .
CLINICAL SCIENCE, 1993, 84 (04) :469-475