Urinary angiotensin-converting enzyme activity in type 2 diabetes mellitus: its relationship to diabetic nephropathy

Miyauchi, Eiji; Hosojima, Hiroyuki; Morimoto, Shinji

doi:10.1007/bf00838491

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…Nosadini 216 was not selected as no normoalbuminuric control group was included in the article. Miyauchi, 217 Wirta, 218 Friis and Pedersen 66 and Berrut 219 were also selected. Features of the seven selected studies are shown in Table 31.…”

Section: Search Resultsmentioning

confidence: 99%

“…Other articles selected were Nelson, 231 John, 90 Beatty, 63 Kawazu, 232 Chan, 61 Miyauchi, 217 Berrut, 219 Song, 233 Tanaka, 150 Nosadini 216 and de Grauw. 72 ( Table 32).…”

Section: Search Resultsmentioning

confidence: 99%

“…For the development of ESRD 176 articles were initially identified, which reduced after applying the protocol requirements to 12 studies; for GFR, 197 articles of potential relevance reduced to seven studies. From among 597 articles for either type 1 or type 2 DM, 16 relevant studies were Systematic review 3 33 Cooper et al, 1988 167 Nelson et al, 1991 231 Nielsen et al, 1993 212 John et al, 1994 90 Kawazu et al, 1994 232 Schmitz et al, 1994 89 Araki et al, 1995 59 Beatty et al, 1995 63 Chan et al, 1995 61 Miyauchi et al, 1995 217 Wirta et al, 1996 218 Berrut et al, 1997 219 Tanaka et al, 1998 150 de Grauw et al, 2001 72 Torffvit and Agardh, 2001 retrieved for the development of clinical proteinuria in type 2 DM; for regression of microalbuminuria there were 14 studies. For patients with microalbuminuria, there is a significantly increased risk of developing ESRD, (RR 3.6, 95% CI 1.6 to 8.4) and clinical proteinuria (RR 7.5, 95% CI 5.2 to 10.9), and a significantly greater decline in GFR of 1.7 (95% CI 0.1 to 3.2) ml per minute per year compared with those who were normoalbuminuric.…”

Section: Type 2 Dmmentioning

confidence: 99%

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Systematic review on urine albumin testing for early detection of diabetic complications

Newman

Mattock²,

Dawnay³

et al. 2005

Health Technol Assess

156

105

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The most pronounced benefits of glycaemic control identified in this review are on retinal and renal complications in both normoalbuminuric and microalbuminuric patients considered together, with little or no evidence of any greater benefit in those with microalbuminuria. Hence, microalbuminuric status may be a false boundary when considering the benefits of glycaemic control. Classification of a person as normoalbuminuric must not serve to suggest that they will derive less benefit from optimal glycaemic control than a person who is microalbuminuric. All hypertensive patients benefit from blood pressure lowering and there is little evidence of additional benefit in those with microalbuminuria. Antihypertensive therapy with an ACE inhibitor in normotensive patients with microalbuminuria is beneficial. Monitoring microalbuminuria does not have a proven role in modulating antihypertensive therapy while the patient remains hypertensive. Recommendations for microalbuminuria research include: determining rate and predictors of development and factors involved in regression; carrying out economic evaluations of different screening strategies; investigating the effects of screening on patients; standardising screening tests to enable use of common reference ranges; evaluating the effects of lipid-lowering therapy; and using to modulate antihypertensive therapy.

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Section: Search Resultsmentioning

confidence: 99%

“…Other articles selected were Nelson, 231 John, 90 Beatty, 63 Kawazu, 232 Chan, 61 Miyauchi, 217 Berrut, 219 Song, 233 Tanaka, 150 Nosadini 216 and de Grauw. 72 ( Table 32).…”

Section: Search Resultsmentioning

confidence: 99%

Section: Type 2 Dmmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review on urine albumin testing for early detection of diabetic complications

Newman

Mattock²,

Dawnay³

et al. 2005

Health Technol Assess

156

105

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“…ACE expression is increased in renal glomeruli (34,51,69) and reduced in tubules of most DKD animal models (51,65,68,69), where ACE protein quantity correlates tightly with its enzymatic activity (65). In human DKD, however, ACE protein is increased in both glomerular and tubular compartments in kidney biopsies (17,30,33,41) and also increased in urine samples from people with DKD (6,15,32). We found increased urine ACE activity in streptozotocin-treated mice and, consistent with ACE overexpression in human kidney biopsies, we found higher urine ACE protein concentration.…”

Section: Discussionmentioning

confidence: 99%

Urine RAS components in mice and people with type 1 diabetes and chronic kidney disease

Wysocki

Goodling

Burgaya³

et al. 2017

American Journal of Physiology-Renal Physiology

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The pathways implicated in diabetic kidney disease (DKD) are largely derived from animal models. To examine if alterations in renin-angiotensin system (RAS) in humans are concordant with those in rodent models, we measured concentration of angiotensinogen (AOG), cathepsin D (CTSD), angiotensin-converting enzyme (ACE), and ACE2 and enzymatic activities of ACE, ACE2, and aminopeptidase-A in FVB mice 13-20 wk after treatment with streptozotocin ( = 9) or vehicle ( = 15) and people with long-standing type 1 diabetes, with ( = 37) or without ( = 81) DKD. In streptozotocin-treated mice, urine AOG and CTSD were 10.4- and 3.0-fold higher than in controls, respectively ( < 0.001). Enzymatic activities of ACE, ACE2, and APA were 6.2-, 3.2-, and 18.8-fold higher, respectively, in diabetic animals ( < 0.001). Angiotensin II was 2.4-fold higher in diabetic animals ( 0.017). Compared with people without DKD, those with DKD had higher urine AOG (170 vs. 15 μg/g) and CTSD (147 vs. 31 μg/g). In people with DKD, urine ACE concentration was 1.8-fold higher (1.4 vs. 0.8 μg/g in those without DKD), while its enzymatic activity was 0.6-fold lower (1.0 vs. 1.6 × 10 RFU/g in those without DKD). Lower ACE activity, but not ACE protein concentration, was associated with ACE inhibitor (ACEI) treatment. After adjustment for clinical covariates, AOG, CTSD, ACE concentration, and ACE activity remained associated with DKD. In conclusion, in mice with streptozotocin-induced diabetes and in humans with DKD, urine concentrations and enzymatic activities of several RAS components are concordantly increased, consistent with enhanced RAS activity and greater angiotensin II formation. ACEI use was associated with a specific reduction in urine ACE activity, not ACE protein concentration, suggesting that it may be a marker of exposure to this widely-used therapy.

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“…A significant increase in urinary levels of NAG at follow‐up was reported in type 2 diabetic patients with nephropathy which was accentuated by the severity of the complication. There was no such increase in patients without nephropathy 158. Moreover, in the UK Prospective Diabetes Study (UKPDS), the occurrence of NAG‐uria among 672 newly diagnosed type 2 diabetic patients was much higher than that of albuminuria (66% and 28%, respectively) 66.…”

Section: Type 2 Diabetes and Markers Of Renal Impairmentmentioning

confidence: 98%

Urinary biomarkers involved in type 2 diabetes: a review

Matheson¹,

Willcox

Flanagan

et al. 2010

Diabetes Metabolism Res

130

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Diabetes mellitus is one of the most challenging health concerns of the 21st century. With at least 30% of the diabetic population remaining undiagnosed, effective and early diagnosis is of critical concern. Development of a diagnostic test, more convenient and reliable than those currently used, would therefore be highly beneficial. Urine as a diagnostic medium allows for non-invasive detection of biomarkers, including some associated with type 2 diabetes and its complications. This review provides a synopsis of those urinary biomarkers that potentially may provide a basis for the development of improved diagnostic tests. Three main pathways for the sourcing of potential makers are identified: kidney damage, oxidative stress and low-grade inflammation including atherosclerosis/vascular damage. This review briefly presents each pathway and some of the most relevant urinary biomarkers that may be used to monitor the development or progression of diabetes and its complications. In particular, biomarkers of renal dysfunction such as transferrin, type IV collagen and N-acetyl-beta-D-glucosaminidase might prove to be more sensitive than urinary albumin, the current gold standard, in the detection of incipient nephropathy and risk assessment of cardiovascular disease. Inflammatory markers including orosomucoid, tumour necrosis factor-alpha, transforming growth factor-beta, vascular endothelial growth factor and monocyte chemoattractant protein-1, as well as oxidative stress markers such as 8-hydroxy-2'deoxyguanosine may also be useful biomarkers for diagnosis or monitoring of diabetic complications, particularly kidney disease. However, the sensitivity of these markers compared with albumin requires further investigation.

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Urinary angiotensin-converting enzyme activity in type 2 diabetes mellitus: its relationship to diabetic nephropathy

Cited by 7 publications

References 20 publications

Systematic review on urine albumin testing for early detection of diabetic complications

Systematic review on urine albumin testing for early detection of diabetic complications

Urine RAS components in mice and people with type 1 diabetes and chronic kidney disease

Urinary biomarkers involved in type 2 diabetes: a review

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