College of Health and Behavioural Sciences, Bangor University, George Building, Bangor, Wales, LL57 2PZ, UK.
Kidney Blood Press Res. 2012;36(1):278-89. doi: 10.1159/000343417. Epub 2012 Nov 28.
We sought to determine if an acute kidney injury biomarker, neutrophil gelatinaseassociated lipocalin (NGAL), would be up-regulated by high-intensity proteinuria-inducing exercise.
A prospective cohort design was utilised. 100 healthy, active adults (mean age 24 ± 4 (SD) years) were screened for post-exercise proteinuria (PeP); 10 PeP positive and 10 PeP negative participants then completed a high-intensity exercise protocol involving an 800 meter sprint. Plasma and urinary NGAL, urinary creatinine, urinary albumin and urine volume were obtained at the following time points: pre-run, immediately post-, 25 minutes, one hour and two hours post-run.
Following high-intensity exercise, 64% of participants had urinary NGAL concentrations above the normal range, particularly at 25 minutes post (P = 0.002). However, there was no difference in NGAL response between PeP positive and negative groups and plasma NGAL was decreased, not elevated, following exercise (P = 0.002). In some individuals normalizing urinary NGAL for urinary creatinine attenuated elevations. Urinary NGAL was also negatively correlated with urine volume (r = -0.701, P = 0.005).
Proteinuria susceptibility did not influence an acute injury biomarker response to exercise. Nevertheless, urinary NGAL was elevated by exercise, possibly due to increased production by the proximal tubule, increased plasma clearance (given the decrease in plasma NGAL) and/or a concentrating effect of exercise-induced oliguria. Until correct normalisation of urinary biomarkers is determined, NGAL should be interpreted cautiously in exercise and acute kidney injury-induced oliguria. The inter-individual NGAL response to exercise also warrants further investigation.
我们旨在确定急性肾损伤生物标志物中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是否会因高强度蛋白尿诱导的运动而被上调。
采用前瞻性队列设计。筛选了 100 名健康、活跃的成年人（平均年龄 24 ± 4（SD）岁）进行运动后蛋白尿（PeP）；10 名 PeP 阳性和 10 名 PeP 阴性参与者随后完成了一项高强度运动方案，包括 800 米冲刺。在以下时间点获得血浆和尿液 NGAL、尿肌酐、尿白蛋白和尿量：跑步前、跑步后即刻、25 分钟、1 小时和 2 小时。
高强度运动后，64%的参与者尿液 NGAL 浓度超过正常范围，特别是在 25 分钟后（P = 0.002）。然而，PeP 阳性和阴性组之间的 NGAL 反应没有差异，并且运动后血浆 NGAL 下降而不是升高（P = 0.002）。在某些个体中，用尿肌酐对尿液 NGAL 进行正常化会减弱升高。尿 NGAL 与尿量呈负相关（r = -0.701，P = 0.005）。
蛋白尿易感性不影响运动对急性损伤生物标志物的反应。然而，运动确实会引起尿 NGAL 升高，可能是由于近端肾小管产生增加、血浆清除率增加（鉴于血浆 NGAL 下降）和/或运动引起的少尿的浓缩作用。在确定尿液生物标志物的正确正常化之前，在运动和急性肾损伤引起的少尿中应谨慎解释 NGAL。个体间对运动的 NGAL 反应也值得进一步研究。
