Papadopoulou-Marketou Nektaria, Margeli Alexandra, Papassotiriou Ioannis, Chrousos George P, Kanaka-Gantenbein Christina, Wahlberg Jeanette
Department of Endocrinology, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden.
Diabetes Centre, Department of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Thivon, 115 27 Athens, Greece.
J Diabetes Res. 2017;2017:7526919. doi: 10.1155/2017/7526919. Epub 2017 May 15.
Type 1 diabetes (T1D) is often associated with early microvascular complications. Previous studies demonstrated that increased systolic (SAP) and diastolic arterial blood pressures (DAP) are linked to microvascular morbidity in T1D. The aim of the study was to investigate the predictive role of neutrophil gelatinase-associated lipocalin (NGAL) in unravelling early cardio-renal dysfunction in T1D.
Two T1D patient groups participating in two-centre prospective cohorts were studied. Group A consisted of 57 participants aged 13.9 years (SD: 3.1) and group B consisted of 59 patients aged 28.0 years (SD: 4.4). Forty-nine healthy children [age: 10.5 years (SD: 6.6)] and 18 healthy adults [age 27.7 years (SD: 4.2)] served as controls. Serum concentrations of NGAL (ELISA) were determined, and SAP and DAP were examined (SAP and DAP also expressed as -scores in the younger group).
NGAL correlated positively with SAP in both patient groups ( = 0.020 and = 0.031, resp.) and SAP -score ( = 0.009) (group A) and negatively with eGFR in both groups ( < 0.001 and < 0.001, resp.).
NGAL may be proposed as a biomarker of early renal dysfunction even in nonalbuminuric T1D patients, since it was strongly associated with renal function decline and increasing systolic arterial pressure even at prehypertensive range in people with T1D, in a broad age range.
1型糖尿病（T1D）常伴有早期微血管并发症。既往研究表明，收缩压（SAP）和舒张压（DAP）升高与T1D患者的微血管病变有关。本研究旨在探讨中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在揭示T1D患者早期心肾功能障碍中的预测作用。
对参与两个中心前瞻性队列研究的两组T1D患者进行研究。A组由57名年龄为13.9岁（标准差：3.1）的参与者组成，B组由59名年龄为28.0岁（标准差：4.4）的患者组成。49名健康儿童[年龄：10.5岁（标准差：6.6）]和18名健康成年人[年龄27.7岁（标准差：4.2）]作为对照。测定血清NGAL浓度（酶联免疫吸附测定法），并检测SAP和DAP（在较年轻组中，SAP和DAP也表示为z评分）。
在两组患者中，NGAL均与SAP呈正相关（分别为r = 0.020和r = 0.031），与A组的SAP z评分呈正相关（r = 0.009），且在两组中均与估算肾小球滤过率（eGFR）呈负相关（分别为P < 0.001和P < 0.001）。
即使在无蛋白尿的T1D患者中，NGAL也可被视为早期肾功能障碍的生物标志物，因为在广泛的年龄范围内，T1D患者即使在血压正常高值范围内，NGAL也与肾功能下降和收缩压升高密切相关。
