Changes of the tubular markers in type 2 diabetes mellitus with glomerular hyperfiltration
Changes of the tubular markers in type 2 diabetes mellitus with glomerular hyperfiltration
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DOI：
10.1016/j.diabres.2011.09.031
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发表时间：
2012-01-01
影响因子：
5.1
通讯作者：
Wang, Qian
中科院分区：
文献类型：
--
作者：
Fu, Wen-Jin;Li, Bao-Liang;Wang, Qian
目的：评估肾小球高滤过（GHF）是否会导致2型糖尿病（T2DM）患者肾小管损伤。方法：根据血清CysC水平确定248名健康个体的估计肾小球滤过率（eGFR）参考值。 GHF 被定义为非糖尿病个体的 eGFR 超过特定性别的第 97.5 个百分位。在本研究中，招募了 30 名 GHF 患者、58 名 GFR 正常的 T2DM 患者和 24 名健康对照者。测量并比较了肾小管标志物，例如尿液 N-乙酰基-β-D-氨基葡萄糖苷酶 (NAG) 和肾损伤分子 1 (KIM-1)，以及血清和尿液中性粒细胞明胶酶相关脂质运载蛋白 (NGAL)。在GHF组中分析这些标志物与eGFR的相关性。结果：与正常GFR组和对照组相比，GHF组尿NGAL和KIM-1水平较高，但血清NGAL水平较低。与对照组相比，正常 GFR 组的血清 NGAL 水平略有下降，尿液 NGAL 水平略有上升。三组尿NAG值无统计学差异。相关分析显示，GHF组eGFR与空腹血糖（FBG）、HbA1c、尿NGAL、KIM-1呈正相关，与血清NGAL呈负相关。结论：合并GHF的T2DM患者尿管损伤标志物高于GFR正常组和对照组，这可能直接证明GHF是糖尿病肾病的有害因素。 (C) 2011 Elsevier Ireland Ltd. 保留所有权利。
Aim: To assess whether glomerular hyperfiltration (GHF) could result in renal tubular damage in type 2 diabetes mellitus (T2DM) patients.Methods: Reference value of estimated glomerular filtration rate (eGFR) was determined in 248 healthy individuals based on serum CysC levels. GHF was defined as an eGFR exceeding the sex-specific 97.5th percentile in non-diabetic individuals. In the present study, 30 with GHF, 58 with norm-GFR T2DM, and 24 healthy controls were recruited. Tubular markers, such as urinary N-acetyl-beta-D-glucosaminidase (NAG) and kidney injury molecule 1 (KIM-1), as well as serum and urinary neutrophil gelatinase-associated lipocalin (NGAL), were measured and compared. The correlation of these markers with eGFR was analyzed in the GHF group.Results: The GHF group had higher urinary NGAL and KIM-1 levels but lower serum NGAL level than the norm-GFR and control groups. Slightly decreased serum NGAL and increased urinary NGAL levels were also noted in the norm-GFR group compared with those of the controls. There was no statistical difference in the urinary NAG values among the three groups. Correlation analysis showed that eGFR was positively related to fasting blood glucose (FBG), HbA1c, urinary NGAL, and KIM-1, but negatively with serum NGAL in the GHF group.Conclusion: Higher urinary tubular damage markers were found in T2DM patients with GHF than the norm-GFR and control groups, probably a direct proof that GHF is a deleterious factor for diabetic nephropathy. (C) 2011 Elsevier Ireland Ltd. All rights reserved.