Associations of urinary, glomerular, and tubular markers with the development of diabetic kidney disease in type 2 diabetes patients

Xu, Jin; Zhang, Qian; Wang, Huabin; Cui, Xiao‐Fan; Li, Rui

doi:10.1002/jcla.22191

Cited by 17 publications

(22 citation statements)

References 21 publications

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“…Urine IgG and transferrin excretion has been previously observed in normoalbuminuric patients with diabetes and has been associated with hypertension and hyperfiltration [ 24 , 25 ]. In accordance with previous studies [ 26 , 27 ], we observed increased urine IgG and transferrin in a subgroup with moderately increased albuminuria and both proteins were specific markers of kidney disease. These are notable observations, especially considering high molecular weight of IgG (150 kDa) that preserves the protein from being filtered by healthy glomeruli [ 28 ].…”

Section: Discussionsupporting

confidence: 93%

Markers of Glomerular and Tubular Damage in the Early Stage of Kidney Disease in Type 2 Diabetic Patients

Żyłka¹,

Dumnicka

Kuśnierz-Cabała

et al. 2018

Mediators of Inflammation

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Diabetic kidney disease develops in half of genetically predisposed patients with type 2 diabetes (T2DM). Early diagnosis of kidney damage and nephroprotective treatment are the ways of preventing the disease progression. Our aim was to evaluate selected laboratory markers of glomerular and tubular damage in T2DM patients with early stages of chronic kidney disease (G1/G2, A1/A2) for their associations with A2 albuminuria and early decline in the estimated glomerular filtration rate (eGFR). Among 80 T2DM patients with median eGFR of 92.4 ml/min/1.73 m2 and median urinary albumin to creatinine ratio (uACR) of 4.69 mg/g, 19 had uACR > 30 mg/g (A2). Higher serum cystatin C, serum and urine neutrophil gelatinase associated lipocalin (NGAL), urine kidney injury molecule 1 (KIM-1), detectable urine transferrin and IgG, and lower serum uromodulin significantly predicted A2 albuminuria, urine KIM-1/creatinine ratio, and IgG being the best predictors. Albuminuria, urine NGAL/creatinine, and IgG correlated with diabetes duration. Albuminuria, urine NGAL, transferrin, IgG, and uromodulin correlated with diabetes control. In a subgroup of 29 patients, retrospective data were available on changes in eGFR and uACR over one year. Decline in eGFR was observed in 17 patients and increase in uACR in 10 patients. Serum and urine NGAL correlated with eGFR changes. Higher urine NGAL, KIM-1/creatinine ratio, and detectable IgG were significantly associated with the increase in uACR. Widely available markers, serum cystatin C, urine IgG, transferrin, and NGAL, may help in early assessment of kidney disease in T2DM patients; however, large prospective studies are needed to confirm the conclusion.

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Section: Discussionsupporting

confidence: 93%

Markers of Glomerular and Tubular Damage in the Early Stage of Kidney Disease in Type 2 Diabetic Patients

Żyłka¹,

Dumnicka

Kuśnierz-Cabała

et al. 2018

Mediators of Inflammation

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“…19,20 In addition, the significant correlation of eGFR with urinary α1-MG/Cr in univariate analysis lost after multivariate analysis, it is different from our previous study in diabetic patients. 11 Similarly, the relatively normal kidney function and younger age may interpret this result, too.…”

Section: Discussionmentioning

confidence: 94%

“…However, there are few detailed and comprehensive studies on the reference interval of urinary α1‐MG concentrations in Chinese people, and we usually refer to the western results. But our recent studies found that, the incidence of elevated urinary α1‐MG/Cr was higher in men than in women, and male was the most important risk factor associated with tubular injury . Similarly, a study about urinary α1‐MG in Singapore also found the urinary α1‐MG excretion increased with age, and was higher in men (1.41 mg/mmol urine creatinine) than in women (1.14 mg/mmol urine creatinine) .…”

Section: Introductionmentioning

confidence: 85%

“…But our recent studies found that, the incidence of elevated urinary α1-MG/Cr was higher in men than in women, 10 and male was the most important risk factor associated with tubular injury. 11 Similarly, a study about urinary α1-MG in Singapore also found the urinary α1-MG excretion increased with age, and was higher in men (1.41 mg/mmol urine creatinine) than in women (1.14 mg/mmol urine creatinine). 5 Therefore, whether there is gender difference in urinary α1-MG/Cr in healthy individuals is not clear so far.…”

Section: Introductionmentioning

confidence: 90%

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A study on the biological reference interval of urinary alpha 1‐microglobulin in a group of Chinese people

Zhang

Cui³

et al. 2017

Clinical Laboratory Analysis

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“… 11 β2-MG and cystatin C are reliable and important markers of renal damage in patients with diabetes, and they are significantly elevated compared with control subjects. 12 , 13 In women with PCOS, cystatin C may be a new strategy in clinical practice for early detection of individuals who are at high risk for long-term metabolic and cardiovascular events. 14 …”

Section: Introductionmentioning

confidence: 99%

Increased risk markers in women with polycystic ovary syndrome and gestational diabetes mellitus during mid-pregnancy

Zhang

Wang

et al. 2020

J Int Med Res

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Objective This study aimed to investigate application of the urine albumin-to-creatinine ratio (ACR), serum beta 2-microglobulin (β2-MG), and cystatin C as risk markers in a cohort of women with polycystic ovary syndrome (PCOS) for the incidence of gestational diabetes mellitus (GDM). Methods In this cross-sectional study, we analyzed 312 pregnant women with PCOS and classified them as those with and without GDM. For all participants, elbow venous blood and clean middle urine were collected in the morning after 8 hours of an empty stomach. Results Logistic regression analysis showed that the ACR, urine β2-MG levels, and serum cystatin C levels were important markers for women with PCOS concomitant with GDM. Receiver operating characteristic curve analysis showed that the area under the curve of CysC was 0.81 with the threshold based on >0.93 and that of β2-MG was 0.72 with the threshold based on >1.25. Conclusions Increased levels of β2-MG and cystatin C and a high ACR might be risk factors for Chinese women with PCOS and GDM during mid-pregnancy.

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Associations of urinary, glomerular, and tubular markers with the development of diabetic kidney disease in type 2 diabetes patients

Cited by 17 publications

References 21 publications

Markers of Glomerular and Tubular Damage in the Early Stage of Kidney Disease in Type 2 Diabetic Patients

Markers of Glomerular and Tubular Damage in the Early Stage of Kidney Disease in Type 2 Diabetic Patients

A study on the biological reference interval of urinary alpha 1‐microglobulin in a group of Chinese people

Increased risk markers in women with polycystic ovary syndrome and gestational diabetes mellitus during mid-pregnancy

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