Clinical implication of urinary tubular markers in the early stage of nephropathy with type 2 diabetic patients
Clinical implication of urinary tubular markers in the early stage of nephropathy with type 2 diabetic patients
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DOI：
10.1016/j.diabres.2012.02.019
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发表时间：
2012-08-01
影响因子：
5.1
通讯作者：
Kim, Yong Ki
中科院分区：
文献类型：
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作者：
Kim, Sang Soo;Song, Sang Heon;Kim, Yong Ki
目的：探讨尿小管标志物、白介素18(IL-18)和血管紧张素原与2型糖尿病早期肾病蛋白尿的关系。方法：检测118例2型糖尿病患者和25例非糖尿病对照组尿中肾小管标志物(肾损伤分子[KIM]-1、中性粒细胞明胶酶相关脂蛋白(NGAL)和肝型脂肪酸结合蛋白[L-FABP])、促炎标志物(IL-18)和肾内肾素-血管紧张素系统(RAS)状态标志物(血管紧张素原)水平，估计肾小球滤过率(FR)和GT；结果：大量白蛋白尿组尿Kim-1、NGAL、IL-18和血管紧张素原水平显著高于对照组、正常白蛋白尿组和微量白蛋白尿组，而正常白蛋白尿组和正常白蛋白尿组之间差异无统计学意义。尿小管标志物与尿IL-18、血管紧张素原呈正相关。在单因素分析中，尿白蛋白尿与所有调查的尿标志物相关。调整多项临床参数后，尿Kim-1、NGAL和血管紧张素原与蛋白尿显著相关。结论：本研究结果提示尿小管标志物可能与2型糖尿病肾病早期蛋白尿独立相关(EGFR和Gt；=60mL/min/1.73m(2))，并可能反映炎症过程和肾内RAS的激活。(C)2012爱思唯尔爱尔兰有限公司。保留所有权利。
Aim: The aim of this study was to evaluate the association of urinary tubular markers, interleukin-18 (IL-18) and angiotensinogen with albuminuria in early nephropathy of type 2 diabetics.Methods: Urine levels of tubular markers (kidney injury molecule [KIM]-1, neutrophil gelatinase-associated lipocalin [NGAL] and liver-type fatty acid-binding protein [L-FABP]), proinflammatory marker (IL-18), and a marker of intrarenal renin-angiotensin system (RAS) status (angiotensinogen) were determined in 118 patients with type 2 diabetes mellitus and 25 non-diabetic controls with estimated glomerular filtration rate (eGFR) >= 60 mL/min/1.73 m(2).Results: Urinary levels of KIM-1, NGAL, IL-18 and angiotensinogen were significantly higher in macroalbuminuria group compared with control and normo- and microalbuminuria groups but not significantly different between control and normoalbuminuria group. Urinary tubular markers were positively correlated with urinary IL-18 and angiotensinogen, respectively. The urinary albuminuria was correlated with all investigated urinary markers in univariate analysis. After adjusting for several clinical parameters, urinary KIM-1, NGAL and angiotensinogen were significantly associated with albuminuria.Conclusions: The results of this study suggest that urinary tubular markers may be independently associated with albuminuria in the early stage of nephropathy in type 2 diabetics (eGFR >= 60 mL/min/1.73 m(2)) and may reflect inflammatory processing and the activation of the intrarenal RAS. (C) 2012 Elsevier Ireland Ltd. All rights reserved.