Assal Heba S, Tawfeek Salwa, Rasheed Enas A, El-Lebedy Dalia, Thabet Eman H
Department of Internal Medicine, Medical Research Division, National Research Centre, Egypt.
Clin Med Insights Endocrinol Diabetes. 2013 Jul 31;6:7-13. doi: 10.4137/CMED.S12633. eCollection 2013.
Renal tubulointerstitium plays an important role in the development and progression of diabetic nephropathy. The aim of this study was to assess serum cystatin C and 2 renal tubular enzymes, neutrophil gelatinase associated lipocalin (NGAL) and N-acetyl-beta-D-glucosaminidase (NAG), as screening markers for early renal dysfunction in patients with type 2 diabetes mellitus (T2DM). ROC curve analysis showed that urinary NAG is the most sensitive marker of microalbuminuria and early renal damage with sensitivity of 83.3%, while serum cystatin C was the most sensitive and specific marker of macroalbuminuria and damage progress with sensitivity of 70.8% and specificity of 83.3% versus 70.6% and 83.3% for uNGAL; and 64.7% and 66.7% for NAG, respectively. Our data indicate that urinary NAG is the most sensitive marker for early renal damage in diabetic patients. However, for damage progress, serum cystatin C is the most sensitive and specific marker for follow-up and monitoring renal dysfunction.
肾小管间质在糖尿病肾病的发生和发展中起重要作用。本研究的目的是评估血清胱抑素C以及两种肾小管酶，即中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和N-乙酰-β-D-氨基葡萄糖苷酶（NAG），作为2型糖尿病（T2DM）患者早期肾功能不全的筛查指标。ROC曲线分析表明，尿NAG是微量白蛋白尿和早期肾损伤最敏感的指标，敏感性为83.3%，而血清胱抑素C是大量白蛋白尿和损伤进展最敏感和特异的指标，敏感性为70.8%，特异性为83.3%，相比之下，尿NGAL的敏感性和特异性分别为70.6%和83.3%；NAG的敏感性和特异性分别为64.7%和66.7%。我们的数据表明，尿NAG是糖尿病患者早期肾损伤最敏感的指标。然而，对于损伤进展，血清胱抑素C是随访和监测肾功能不全最敏感和特异的指标。
