Suh Jin-Soon, Kim Shin-Hee, Cho Kyoung Soon, Jung In-Ah, Cho Won Kyoung, Jeon Yeon Jin, Jung Min Ho, Suh Byoung Kyu
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Pediatr Nephrol. 2016 Apr;31(4):623-31. doi: 10.1007/s00467-015-3253-9. Epub 2015 Nov 2.
The aim of this study was to evaluate the association of a urinary tubular marker, liver-type fatty acid binding protein (L-FABP) and an inflammatory marker, serum/urinary YKL-40, with albuminuria in patients with childhood-onset type 1 diabetes (T1D).
Twenty-nine patients with childhood-onset T1D and 32 controls were enrolled. Serum and urinary concentrations of YKL-40 and urinary concentrations of L-FABP were measured.
The serum levels of YKL-40 were not significantly different between the control group and the patient groups. However, the levels of urinary YKL-40/creatinine (Cr) were higher in the patients, even those with normoalbuminuria than in the controls (p < 0.001). The levels of urinary L-FABP/Cr were not different between the control group and the patient groups. However, the level of urinary L-FABP/Cr in the microalbuminuria group was higher than that in the normoalbuminuria group (p = 0.03). There were no associations between the levels of urinary albumin-to-creatinine ratio and urinary L-FABP/Cr or YKL-40/Cr. However, the urinary L-FABP/Cr level was significantly correlated with the hemoglobin A1C level (p = 0.005) and the urinary YKL-40/Cr level (p = 0.043).
Urinary L-FABP/Cr and YKL-40/Cr may reflect renal injury in early stages of nephropathy in patients with childhood-onset T1D, even in the normoalbuminuric state.
本研究旨在评估肾小管标志物肝型脂肪酸结合蛋白（L-FABP）和炎症标志物血清/尿YKL-40与儿童期发病的1型糖尿病（T1D）患者蛋白尿的相关性。
纳入29例儿童期发病的T1D患者和32例对照。测量血清和尿液中YKL-40的浓度以及尿液中L-FABP的浓度。
对照组和患者组之间YKL-40的血清水平无显著差异。然而，患者尿液中YKL-40/肌酐（Cr）水平较高，即使是那些尿白蛋白正常的患者，也高于对照组（p<0.001）。对照组和患者组之间尿液L-FABP/Cr水平无差异。然而，微量白蛋白尿组尿液L-FABP/Cr水平高于正常白蛋白尿组（p=0.03）。尿白蛋白/肌酐比值与尿液L-FABP/Cr或YKL-40/Cr水平之间无相关性。然而，尿液L-FABP/Cr水平与糖化血红蛋白A1C水平显著相关（p=0.005），与尿液YKL-40/Cr水平也显著相关（p=0.043）。
尿液L-FABP/Cr和YKL-40/Cr可能反映儿童期发病的T1D患者肾病早期的肾损伤，即使在尿白蛋白正常的状态下也是如此。
