Proteinuria and enzymuria in non-insulin-dependent diabetics

Koh, Kwang-wook; Chia, K S; Tan, Chorh-Chuan

doi:10.1016/0168-8227(93)90081-f

Cited by 13 publications

(10 citation statements)

References 15 publications

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“…This question, however, has to be addressed in a prospective study correlating long-term follow-up of these subjects. The consistent correlation between p-NAG and the indices of metabolic control confirms previous find ings from other researchers that the excretion rate of this enzyme is influenced by derangement in glucose metabo lism [22][23][24][25], Ikcnaga et al [23] and Poon et al [25] have previously shown that, in non-IDDM subjects, the im provement in glycaemic control reduces but does not nor malize P-NAG excretion.…”

Section: Discussionsupporting

confidence: 76%

“…The relationship between p-NAG and albumin has pre viously been reported both in diabetic subjects [21][22][23][24][25][26] and essential hypertensive subjects [27] and can be ex plained assuming that the excretion of p-NAG is an expression of tubular workload [23] and/or ischaemia [27]. Whatever the explanation to confirm that an asso ciation exists also in normotensive, normoalbuminuric IDDM subjects, adds weight to the concept that there is a certain degree of parallelism over the propension of glo merular and tubular damage in disease states such as hypertension and IDDM.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Measures of Tubular Function in Normoalbuminuric Insulin-Dependent Diabetic Patients and Their Relationship with Sodium Lithium Countertransport Activity

Catalano

Winocour²,

Parlongo³

et al. 1996

Nephron

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The aim of this study was to assess the relationship between markers of tubular function, markers of glycaemic control and erythrocyte sodium-lithium countertransport activity (SLC) in 40 normotensive, normoalbuminuric insulin-dependent diabetic (IDDM) subjects and 11 normal control subjects. Nine IDDM subjects had SLC > 0.40 mmol lithium h-1 litre RBC-1. Glomerular filtration rate (GFR) and the excretion rate of retinol-binding protein (RBP), N-acetyl-β-D-glucosaminidase (β-NAG) and glucose were significantly higher in IDDM subjects compared to control subjects (Mann-Whitney test, p = 0.02, < 0.001, < 0.001 and < 0.001, respectively), whilst the two groups had similar SLC and TmPO₄ levels. There was no significant relationship between SLC and the other variables in IDDM subjects, even when comparing IDDM subjects with normal and high SLC. β-NAG excretion rate was correlated to urinary glucose (r_s 0.47, p = 0.001) and, weakly, to the other markers of glycaemic control (fasting blood glucose r_s = 0.31, p = 0.03, fructosamine r_s 0.28, p = 0.04, HbA[ r_s 0.27, p = 0.04). RBP excretion rate was correlated to the excretion rate of β-NAG (r_s 0.38; p = 0.007) and albumin (r_s 0.45; p = 0.002); the excretion rates of β-NAG and albumin were significantly associated (r_s0.37, p = 0.009). Diabetes duration did not correlate to any of the aforementioned variables. In this study, β-NAG and RBP overnight excretion rates were higher in normoalbuminuric IDDM subjects compared to control subjects but no relationship was present between SLC and tubular function in IDDM patients without complications. Excretion rates of different proteins appear to be interrelated and, in IDDM, β-NAG excretion is associated with glycaemic control.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Measures of Tubular Function in Normoalbuminuric Insulin-Dependent Diabetic Patients and Their Relationship with Sodium Lithium Countertransport Activity

Catalano

Winocour²,

Parlongo³

et al. 1996

Nephron

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show abstract

“…However, when adjusted for albuminuria, only the association between H-FABP and eGFR remained significant [32]. The utility of urinary NAG as an early biomarker is still a possibility as much evidence exists for its presence in normoalbuminuria [12,[32][33][34]. In an in- treated with patients with an angiotensin-receptor blocker and followed their urinary NGAL, KIM-1, and liver fatty acid-binding protein (L-FABP) levels for 3 years [35].…”

Section: Non-traditional Protein Markersmentioning

confidence: 98%

Biomarkers of Diabetic Nephropathy, the Present and the Future

Jim¹,

Santos²,

Spath³

et al. 2012

CDR

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Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. Searching for the perfect biomarker of DN has become the holy grail of nephrology since the burden of this disease is untenable. The only feasible way to tackle this health care crisis is by prevention and treatment in a mechanistically rational approach. Therefore, the discovery of a specific, reliable diagnostic and prognostic biomarker for DN is imperative. Part of the difficulty in finding such a marker is the complex pathogenesis of DN; it is clearly multifactorial and involves multiple genes, proteins, metabolic pathways, and environmental factors. In this review, we will discuss the latest findings in the use of genetic, protein, and metabolic markers of DN. Particular attention will be paid to the urinary biomarker as a noninvasive method to detect either morphological or biochemical changes in DN. Urinary protein and mRNA studies have focused on either the glomerular (podocyte-specific) or tubular components (matrix or injury-related) of the nephron. The virtues and pitfalls of using the podocyte as a biomarker will be discussed. The systems biology approach of biomarker discovery in the studies of genomics, transcriptomics, proteomics, and metabolomics will be explored. Despite significant numbers of new biomarkers described, most studies are limited by either their small sample size or their cross-sectional nature, so that the ability to predict future and severity of DN is lacking. In order to successfully search for the ideal, validated biomarker, we need to conduct large, prospective, multi-center trials enlisting both Type 1 and Type II diabetic patients with and without nephropathy for at least two decades.

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“…Studies have demonstrated a significant increase in urinary NAG excretion in type 2 diabetics compared with controls [15–17]. A progressive rise in the levels corresponding to poor glycemic control has been noted [15] with reduced levels seen after good glycemic control [18]. In the UKPDS study, NAG levels at diagnosis were much higher in diabetics compared to albumin excretion and it appears that the levels are elevated even in those with normoalbuminuria.…”

Section: Introductionmentioning

confidence: 99%

Association between Urinary N-Acetyl-Beta-D-Glucosaminidase and Microalbuminuria in Diabetic Black Africans

Udomah

Ekrikpo

Effa

et al. 2012

International Journal of Nephrology

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Diabetes mellitus is the commonest cause of ESRD worldwide and third most common cause in Nigeria. Recent reports from Nigeria indicate the prevalence of diabetic nephropathy as an aetiology of ESRD is increasing necessitating early diagnosis of diabetic nephropathy. We measured the urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG), NAG/creatinine ratio, urinary protein-creatinine ratio and calculated eGFR in 30 recently diagnosed nonhypertensive diabetics and 67 controls. The age and sex distribution, systolic blood pressure, serum and urinary creatinine were similar for both groups. There was higher urinary excretion of NAG (304 versus 184 μmol/h/L, P < 0.001) and NAG/creatinine ratio (21.2 versus 15.7 μmol/h/L/mmolCr, P < 0.001) in the diabetics than controls. There was a strong correlation between NAG/creatinine ratio and albumin/creatinine ratio (r = 0.74, P < 0.001). A multivariate linear regression model showed a significant linear relationship between NAG/creatinine ratio and albumin/creatinine ratio after adjusting for the effect of blood pressure, age, sex, and serum creatinine. The strong association found between albumin/creatinine ratio and NAG/creatinine ratio perhaps indicates the need for further investigation of the clinical utility of NAG/creatinine ratio as a screening tool for early nephropathy in African diabetics.

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Proteinuria and enzymuria in non-insulin-dependent diabetics

Cited by 13 publications

References 15 publications

Measures of Tubular Function in Normoalbuminuric Insulin-Dependent Diabetic Patients and Their Relationship with Sodium Lithium Countertransport Activity

Measures of Tubular Function in Normoalbuminuric Insulin-Dependent Diabetic Patients and Their Relationship with Sodium Lithium Countertransport Activity

Biomarkers of Diabetic Nephropathy, the Present and the Future

Association between Urinary N-Acetyl-Beta-D-Glucosaminidase and Microalbuminuria in Diabetic Black Africans

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