Features of biochemical parameters in healthy and patients with type 1 diabetes mellitus with different levels of albumin in the urine

Abstract

The use of multi-label biochemical panels is justified by the fact that different markers reflect the severity of various pathological processes (disorders of carbohydrate and fat metabolism), which in their interaction are indicators of decompensation of a single pathology – diabetes in particular. The aim of the work was to study the differences in biochemical parameters in healthy and patients with type 1 diabetes mellitus (T1D) depending on the level of albumin in the urine. 78 men and 62 women aged 22-26 years, patients with diabetes mellitus type 1, who were hospitalized in the therapeutic department в № 1 and № 2 of Vinnytsia Regional Highly Specialized Endocrinology Center and 8 practically healthy men and 13 practically healthy women of the same age were examined. The level of microalbuminuria was determined in all patients by enzyme-linked immunosorbent assay. Fasting blood glucose and 2 hours after a meal were determined by enzymatic, amperometric analysis on a biochemical analyzer Biosen C_Line, manufactured by EKF Diagnostic (Germany). The average value of blood glucose was calculated mathematically. To determine glycated hemoglobin (HbA1c), we used the method of high performance liquid chromatography on a D 10 analyzer, manufactured by Bio-Rad (USA). The International Normal Ratio (INR) was determined using a set of reagents to determine the prothrombin time, prothrombin ratio and international sensitivity index, which is specified in the passport to the set (manufacturer of PC-K-TEST "Granum"). Total cholesterol and triglycerides were determined by colorimetric photometric method (using enzymes) on a biochemical analyzer using standard kits from Olympus AU480 (USA). Statistical processing of the results was performed in the license package "Statistica 5.5", using non-parametric evaluation methods. When comparing the level of biochemical parameters between patients with T1D and normo-, microalbuminuria and proteinuria with healthy men or women, patients found higher values: fasting glucose (in men – by 29.1 %, 30.9 % and 42.0 %; in women – by 29.7 %, 33.2 % and 46.0 %); glucose 2 hours after exercise (for men – by 27.4 %, 30.8 % and 36.1 %; for women – by 30.4 %, 32.4 % and 40.2 %); the average value of glucose (for men – by 26.2 %, 30.8 % and 39.3 %; for women – by 28.7 %, 34.0 % and 43.1 %); glycated hemoglobin (47.8 %, 48.8 % and 45.8 % for men; 27.2 %, 50.2 % and 54.4 % for women). Also, in patients with T1D men and proteinuria and women with normoalbuminuria and proteinuria compared with healthy men or women found higher cholesterol values (17.8 % in men and 7.6 % and 26.0 % in women); and in patients with T1D men with proteinuria compared to healthy men – 31.3 % higher triglyceride levels. When comparing the level of biochemical parameters between patients with T1D in men or women with proteinuria, higher values were found: fasting glucose compared with men with normoalbuminuria by 22.2 % and with women with normoalbuminuria by 30.3 % and microalbuminuria by 23.7 %; the average value of glucose compared with men with normoalbuminuria by 20.8 % and microalbuminuria by 14.0 %; glycated hemoglobin compared to women with normoalbuminuria by 15.9 %; compared with men with normoalbuminuria and microalbuminuria – by 24.8 % and 20.3 %, or with women with normoalbuminuria and microalbuminuria – by 24.9 % and 28.0 %; triglycerides compared with men with normoalbuminuria by 23.0 %. When comparing the sex differences in the level of biochemical parameters between healthy or between patients with T1D and normo-, microalbuminuria and proteinuria in men and women, only higher values of glycated hemoglobin by 14.1 % in women with proteinuria and total cholesterol by 8.3 % in women with normoalbuminuria were found. Thus, between healthy and patients with T1D and different levels of albuminuria there are differences in biochemical parameters, and they are greater the higher the level of albumin in the urine.

Relationship between biochemical parameters and glomerular filtration rate by Cockcroft-Gault, CKD EPI and cystatin C in patients with type 1 diabetes

“…In previous publications [13][14][15][16] it was found that in patients with T1D renal dysfunction in the early stages is manifested by impaired filtration function, characterized by increased serum levels of cystatin C and, accordingly, a decrease in GFR by cystatin C, and at later stages -a decrease in GFR, calculated on creatinine (by Cockcroft-Gault and CKD EPI), increase in urinary albumin, albumincreatinine ratio and serum creatinine. Accordingly, the assessment of the rate of change of glomerular filtration and its correlation analysis with classical markers of renal pathology made it possible to detail the diagnosis in patients with T1D at different stages of DN.…”