Urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin as indicators of tubular damage in normoalbuminuric patients with type 2 diabetes
Urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin as indicators of tubular damage in normoalbuminuric patients with type 2 diabetes
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DOI：
10.1016/j.clinbiochem.2015.10.016
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发表时间：
2016-02-01
影响因子：
2.8
通讯作者：
Moresco, Rafael N.
中科院分区：
文献类型：
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作者：
de Carvalho, Jose Antonio M.;Tatsch, Etiane;Moresco, Rafael N.
目的：已有白蛋白尿正常患者出现肾功能障碍的报道，这表明有必要改进糖尿病肾病 (DKD) 研究的诊断和预后工具。因此，本研究的目的是探讨白蛋白尿正常或轻度升高的2型糖尿病（DM）患者尿中中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和肾损伤分子1（KIM-1）水平是否升高。设计和方法：在本研究中，117名2型DM患者根据尿白蛋白/肌酐比值（uACR）分为三组：uACR < 10 mg/g 肌酐、uACR 10-30 mg/g 肌酐和 uACR > 30 mg/g 肌酐均被纳入。测量 KIM-1 (uKIM-1) 和 NGAL (uNGAL) 的尿液浓度。结果：uKIM-1 水平从 uACR < 10 mg/g 肌酐 (69.0 +/- 20.8 pg/ml) 逐渐增加到 uACR 10-30 mg/g 肌酐 (106.1 +/- 41.2 pg/ml) 和 uACR > 30毫克/克肌酐 (166.0 +/- 31.9 pg/ml) (P < 0.001)。此外，uNGAL水平从uACR < 10 mg/g肌酐（29.5 +/- 8.8 ng/ml）逐渐增加到uACR 10-30 mg/g肌酐（51.7 +/- 10.9 ng/ml），再到uACR > 30 mg/g肌酐（71.0 +/- 9.6 ng/ml）（P b 0.001）患者。同样，在 uACR 10-30 mg/g 肌酐的患者中，通过尿肌酐调整后的 uKIM-1 和 uNGAL 均升高。 uACR、uKIM-1和uNGAL之间存在显着的正相关关系。结论：在蛋白尿正常或轻度升高的2型糖尿病患者中，uKIM-1和uNGAL升高，这表明即使在DKD的早期阶段，也可能发生肾小管和肾小球损伤。 (C) 2015 年加拿大临床化学家协会。由爱思唯尔公司出版。保留所有权利。
Objectives: Renal dysfunction has been reported in normoalbuminuric patients, demonstrating the necessity to improve the diagnostic and prognostic tools for diabetic kidney disease (DKD) investigation. Therefore, the aim of this study was to investigate whether the urinary levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) are increased in type 2 diabetes mellitus (DM) patients with normal or mildly increased albuminuria.Design and methods: In this study, 117 type 2 DM patients classified into three groups according to urinary albumin/creatinine ratio (uACR): uACR < 10 mg/g creatinine, uACR 10-30 mg/g creatinine and uACR > 30 mg/g creatinine were enrolled. Urinary concentrations of KIM-1 (uKIM-1) and NGAL (uNGAL) were measured.Results: uKIM-1 levels increased progressively from uACR < 10 mg/g creatinine (69.0 +/- 20.8 pg/ml) to uACR 10-30 mg/g creatinine (106.1 +/- 41.2 pg/ml) and to uACR > 30 mg/g creatinine (166.0 +/- 31.9 pg/ml) (P < 0.001). In addition, uNGAL levels increased progressively from uACR < 10 mg/g creatinine (29.5 +/- 8.8 ng/ml) to uACR 10-30 mg/g creatinine (51.7 +/- 10.9 ng/ml) and to uACR > 30 mg/g creatinine (71.0 +/- 9.6 ng/ml) (P b 0.001) patients. Similarly, both uKIM-1 and uNGAL adjusted by urinary creatinine were increased in patients with uACR 10-30 mg/g creatinine. Significant and positive correlations were observed between uACR, uKIM-1 and uNGAL.Conclusions: uKIM-1 and uNGAL were increased in type 2 DM patients with normal or mildly increased albuminuria, which indicates that tubular and glomerular injuries may be occurring even at the earliest stage of DKD. (C) 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.