Urinary Biomarkers in the Assessment of Early Diabetic Nephropathy.
Urinary Biomarkers in the Assessment of Early Diabetic Nephropathy.
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DOI：
10.1155/2016/4626125
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发表时间：
2016
影响因子：
4.3
通讯作者：
Timar B
中科院分区：
文献类型：
--
作者：
Gluhovschi C;Gluhovschi G;Petrica L;Timar R;Velciov S;Ionita I;Kaycsa A;Timar B
糖尿病肾病（DN）是糖尿病（DM）常见的严重并发症。在早期阶段的诊断可能允许及时干预和改善预后。为此目的，可以使用用于检测早期DN的生物标志物。微量白蛋白尿已被证明是一个非常有用的生物标志物，用于诊断DN，评估其相关的条件，主要是心血管疾病，并监测其进展。新的研究指出，这些生物标志物中的一些（即，肾小球、肾小管、炎症标志物和氧化应激的生物标志物）在一些患者中先于蛋白尿。然而，它们的有用性在文献中被广泛讨论，并且尚未导致用于早期诊断DN的新的“金标准”生物标志物的验证。目前，微量白蛋白尿是肾小球和肾小管损伤的重要生物标志物。其他肾小球生物标志物（转铁蛋白和血浆铜蓝蛋白）正在评估中。肾小管生物标志物在DN的早期诊断中似乎是至关重要的，因为肾小管病变发生在早期。此外，炎症生物标志物、氧化应激、足细胞生物标志物和血管生物标志物已用于评估早期DN。本文综述了目前用于早期DN诊断的生物标志物。
Diabetic nephropathy (DN) is a frequent and severe complication of diabetes mellitus (DM). Its diagnosis in incipient stages may allow prompt interventions and an improved prognosis. Towards this aim, biomarkers for detecting early DN can be used. Microalbuminuria has been proven a remarkably useful biomarker, being used for diagnosis of DN, for assessing its associated condition—mainly cardiovascular ones—and for monitoring its progression. New researches are pointing that some of these biomarkers (i.e., glomerular, tubular, inflammation markers, and biomarkers of oxidative stress) precede albuminuria in some patients. However, their usefulness is widely debated in the literature and has not yet led to the validation of a new “gold standard” biomarker for the early diagnosis of DN. Currently, microalbuminuria is an important biomarker for both glomerular and tubular injury. Other glomerular biomarkers (transferrin and ceruloplasmin) are under evaluation. Tubular biomarkers in DN seem to be of a paramount importance in the early diagnosis of DN since tubular lesions occur early. Additionally, biomarkers of inflammation, oxidative stress, podocyte biomarkers, and vascular biomarkers have been employed for assessing early DN. The purpose of this review is to provide an overview of the current biomarkers used for the diagnosis of early DN.