Demir Korcan, Abaci Ayhan, Küme Tuncay, Altincik Ayça, Catli Gönül, Böber Ece
Department of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
J Pediatr Endocrinol Metab. 2012;25(5-6):517-23.
The aims of this study were to determine neutrophil gelatinase-associated lipocalin (NGAL) levels in normoalbuminuric and normotensive adolescents with type 1 diabetes and to assess the relationship between NGAL and clinical and laboratory variables.
Forty-six adolescents with type 1 diabetes [male/ female (M/F) ratio, 24/22; median age, 14.5 years; range, 12.2-16 years; diabetes duration, 4.8 years; range, 2.6-6.7 years; hemoglobin A1c (HbA1c), 7.9%; range, 7.2%-9.2%] and 21 healthy controls (M/F, 7/14; median age, 14.8 years; range, 13.6-15.5 years) were compared regarding clinical, laboratory, and ambulatory blood pressure monitoring variables.
Median blood and urine glucose, HbA1c, urine NGAL/creatinine ratio [13.2 (range, 8.3-43.1) vs. 4.8 (range, 2.9-20.2), p = 0.015], and daytime systolic and diastolic blood pressure (BP) standard deviation score and BP loads were found higher in diabetic adolescents. Urine NGAL levels were found to be correlated with albumin/creatinine ratio (r = 0.452, p = 0.002), whereas plasma NGAL levels were correlated with nighttime systolic BP load (r = 0.309, p = 0.037). Patients with high-normal albuminuria (n=6) had higher urine NGAL levels [48.7 ng/mL (range, 27.9-149.1 ng/mL) vs. 14.3 ng/mL (range, 3.5-41 ng/mL), p = 0.014] and urine NGAL/creatinine ratio [39.3 ng/mg (range, 21.1-126.3 ng/mg) vs. 11.8 ng/mg (range, 6.3-40.9 ng/mg), p = 0.03] compared with those of controls and higher urine NGAL levels compared with that of diabetic adolescents with low-normal albuminuria [n=40, 11.2 ng/mL (range, 6-23.4 ng/mL), p = 0.004].
Normoalbuminuric and normotensive adolescents with type 1 diabetes have elevated urinary NGAL values, which might indicate kidney injury.
本研究旨在测定1型糖尿病正常白蛋白尿和血压正常青少年的中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平，并评估NGAL与临床及实验室变量之间的关系。
比较46例1型糖尿病青少年[男/女（M/F）比例为24/22；中位年龄14.5岁；范围12.2 - 16岁；糖尿病病程4.8年；范围2.6 - 6.7年；糖化血红蛋白（HbA1c）7.9%；范围7.2% - 9.2%]和21名健康对照者[M/F为7/14；中位年龄14.8岁；范围13.6 - 15.5岁]的临床、实验室及动态血压监测变量。
糖尿病青少年的血糖、糖化血红蛋白、尿NGAL/肌酐比值[13.2（范围8.3 - 43.1）对4.8（范围2.9 - 20.2），p = 0.015]以及日间收缩压和舒张压标准差评分及血压负荷均较高。尿NGAL水平与白蛋白/肌酐比值相关（r = 0.452，p = 0.002），而血浆NGAL水平与夜间收缩压负荷相关（r = 0.309，p = 0.037）。高正常白蛋白尿患者（n = 6）的尿NGAL水平[48.7 ng/mL（范围27.9 - 149.1 ng/mL）对14.3 ng/mL（范围3.5 - 41 ng/mL），p = 0.014]和尿NGAL/肌酐比值[39.3 ng/mg（范围21.1 - 126.3 ng/mg）对11.8 ng/mg（范围6.3 - 40.9 ng/mg），p = 0.03]高于对照组，且尿NGAL水平高于低正常白蛋白尿的糖尿病青少年[n = 40，11.2 ng/mL（范围6 - 23.4 ng/mL），p = 0.004]。
1型糖尿病正常白蛋白尿和血压正常的青少年尿NGAL值升高，这可能提示肾脏损伤。
