Urinary biomarkers for early diabetic nephropathy in type 2 diabetic patients.
Urinary biomarkers for early diabetic nephropathy in type 2 diabetic patients.
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DOI：
10.1186/s40364-015-0042-3
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发表时间：
2015
影响因子：
11.1
通讯作者：
Fiseha T
中科院分区：
文献类型：
--
作者：
Fiseha T
糖尿病肾病（DN）是糖尿病的一种严重并发症，与死亡风险以及心血管和肾脏结局风险增加相关。早期检测 DN 的诊断标志物非常重要，因为早期干预可以减缓肾功能丧失并改善患者预后。糖尿病患者的尿液生物标志物甚至在微量白蛋白尿出现之前就可能升高，并且可以作为检测白蛋白尿正常（早期 DN）患者肾病的有用标志物。我们回顾了一些新的重要的尿液生物标志物，例如：中性粒细胞明胶酶相关脂质运载蛋白 (NGAL)、N-乙酰基-β-氨基葡萄糖苷酶 (NAG)、胱抑素 C、α1-微球蛋白、免疫球蛋白 G 或 M、IV 型胶原、去氧肾上腺素、血管紧张素原和肝型脂肪 酸结合蛋白（L-FABP）与 2 型糖尿病患者早期 DN 相关。我们的检索共确定了迄今为止已发表的 42 项研究。与非糖尿病对照组相比，2 型糖尿病患者的尿液中这些生物标志物水平升高，包括没有肾病迹象（无微量白蛋白尿）的患者，并且与白蛋白尿呈正相关。尽管这些新的尿液生物标志物前景广阔，但仍需要进一步的大型、多中心前瞻性研究来证实它们作为日常实践中早期 2 型 DN 筛查工具的临床实用性。
Diabetic nephropathy (DN) is a serious complication of diabetes associated with increased risk of mortality, and cardiovascular and renal outcomes. Diagnostic markers to detect DN at early stage are important as early intervention can slow loss of kidney function and improve patient outcomes. Urinary biomarkers may be elevated in diabetic patients even before the appearance of microalbuminuria, and can be used as useful marker for detecting nephropathy in patients with normoalbuminuria (early DN). We reviewed some new and important urinary biomarkers, such as: Neutrophil gelatinase associated lipocalin (NGAL), N-acetyl-beta-glucosaminidase (NAG), Cystatin C, alpha 1-microglobulin, immunoglobulin G or M, type IV collagen, nephrin, angiotensinogen and liver-type fatty acid–binding protein (L-FABP) associated with early DN in type 2 diabetic patients. Our search identified a total of 42 studies that have been published to date. Urinary levels of these biomarkers were elevated in type 2 diabetic patients compared with non-diabetic controls, including in patients who had no signs indicating nephropathy (without microalbuminuria), and showed positive correlation with albuminuria. Despite the promise of these new urinary biomarkers, further large, multicenter prospective studies are still needed to confirm their clinical utility as a screening tool for early type 2 DN in every day practice.