Vijay Soorampally, Hamide Abdoul, Senthilkumar Gandhipuram Periyasamy, Mehalingam Vadivelan
Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India.
Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India.
Diabetes Metab Syndr. 2018 Sep;12(5):649-652. doi: 10.1016/j.dsx.2018.04.017. Epub 2018 Apr 12.
Renal tubulo-interstitial damage has an important role in the pathogenesis of early diabetic nephropathy. Urinary biomarkers can help in the detection of early nephropathy in type 2 diabetic patients. The aim of this study was to estimate the levels of urinary neutrophil gelatinase associated lipocalin (NGAL) and cystatin-C in type 2 diabetic patients with early diabetic nephropathy & to compare them with diabetic patients without nephropathy and to correlate urinary NGAL and cystatin-C levels with microalbuminuria in them.
Cross-sectional comparative study.
The study was conducted on 126 patients with type 2 diabetes along with 30 control subjects attending the outpatient care department of a tertiary care teaching hospital. There were 3 study groups-diabetic patients with microalbuminuria, diabetic patients without albuminuria and control subjects who were non-diabetic without any renal disease. Details on duration of diabetes and glycemic status were obtained from the patients. Urine examination was done for subjects in all the groups to look for microalbuminuria along with estimation of NGAL and cystatin-C levels. Samples were stored at -20 °C in the deep freezer.
Urinary NGAL and cystatin-C levels were significantly elevated in patients with microalbuminuria (228.18 & 3.23 ng/ml) as compared to those without albuminuria (146.12 & 2.61 ng/ml) and in control subjects (26.56 & 0.30 ng/ml). Urinary NGAL and cystatin-C levels showed a linear correlation with microalbuminuria in diabetic patients.
Urinary NGAL and cystatin-C levels were increased in type 2 diabetic patients with early diabetic nephropathy as compared to patients without nephropathy. Urine NGAL and cystatin-C levels also showed a positive correlation with microalbuminuria (urine albumin-creatinine ratio) in patients with type 2 diabetes mellitus.
肾小管间质损伤在早期糖尿病肾病的发病机制中起重要作用。尿液生物标志物有助于检测2型糖尿病患者的早期肾病。本研究的目的是评估早期糖尿病肾病2型糖尿病患者尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和胱抑素-C的水平，并将其与无肾病的糖尿病患者进行比较，以及将尿NGAL和胱抑素-C水平与其中的微量白蛋白尿进行关联。
横断面比较研究。
本研究对一家三级护理教学医院门诊护理部的126例2型糖尿病患者以及30例对照受试者进行。有3个研究组——微量白蛋白尿的糖尿病患者、无白蛋白尿的糖尿病患者以及无任何肾脏疾病的非糖尿病对照受试者。从患者处获取糖尿病病程和血糖状态的详细信息。对所有组的受试者进行尿液检查以寻找微量白蛋白尿，并同时评估NGAL和胱抑素-C水平。样本保存在-20°C的深冻冰箱中。
与无白蛋白尿的患者（146.12和2.61 ng/ml）及对照受试者（26.56和0.30 ng/ml）相比，微量白蛋白尿患者的尿NGAL和胱抑素-C水平显著升高（228.18和3.23 ng/ml）。糖尿病患者的尿NGAL和胱抑素-C水平与微量白蛋白尿呈线性相关。
与无肾病的患者相比，早期糖尿病肾病2型糖尿病患者的尿NGAL和胱抑素-C水平升高。2型糖尿病患者的尿NGAL和胱抑素-C水平也与微量白蛋白尿（尿白蛋白-肌酐比值）呈正相关。
