Hosny Salwa S, Bekhet Meram M, Hebah Hayam A, Mohamed Nagwa R
Department of Internal Medicine and Endocrinology, Faculty of Medicine - Ain Shams University, Cairo, Egypt.
Department of Internal Medicine and Endocrinology, Faculty of Medicine - Ain Shams University, Cairo, Egypt.
Diabetes Metab Syndr. 2018 Nov;12(6):1019-1024. doi: 10.1016/j.dsx.2018.06.017. Epub 2018 Jun 21.
Diabetes mellitus is the leading cause of end stage renal disease worldwide. Early identification of diabetic nephropathy even before appearance of microalbuminuria is a challenge for early prevention of occurrence and progression of this complication. Neutrophil gelatinase-associated lipocalin is a small protein that belongs to the lipocalin protein. Urinary neutrophil gelatinase-associated lipocalin is a promising early marker in different renal problems.
To measure urinary neutrophil gelatinase-associated lipocalin in type 2 diabetic patients and to assess its role as an early marker for diagnosis of diabetic nephropathy and diabetic retinopathy.
The current study included 60 subjects with type 2 diabetes and 20 healthy control subjects. Diabetic subjects were divided into 3 groups according to urinary albumin creatinine ratio; 20 normoalbuminuric patients, 20 micro-albuminuric patients and 20 macroalbuminuric patients. They were subjected to history taking, full clinical examination, fundus examination, anthropometric measurement, urinary neutrophil gelatinase-associated lipocalin and urinary albumin creatinine ratio.
Urinary neutrophil gelatinase-associated lipocalin was higher in all diabetic groups than in the control group, with no difference in between diabetic groups. The difference was of great value when comparing normoalbuminuric group with control as albumin creatinine ratio was not different while the urinary neutrophil gelatinase-associated lipocalin was statistically significant (5.94 ± 1.85 ng/dl vs 1.96 ± 0.65, p < 0.001). No correlation was found with retinopathy.
Urinary neutrophil gelatinase-associated lipocalin is a sensitive marker for early detection of diabetic nephropathy even in normoalbuminuric patients denoting early tubular damage before microalbuminuria. It is not correlated with retinopathy.
糖尿病是全球终末期肾病的主要病因。在微量白蛋白尿出现之前早期识别糖尿病肾病是预防该并发症发生和进展的一项挑战。中性粒细胞明胶酶相关脂质运载蛋白是一种属于脂质运载蛋白家族的小蛋白。尿中性粒细胞明胶酶相关脂质运载蛋白是不同肾脏问题中有前景的早期标志物。
测定2型糖尿病患者尿中性粒细胞明胶酶相关脂质运载蛋白，并评估其作为糖尿病肾病和糖尿病视网膜病变诊断早期标志物的作用。
本研究纳入60例2型糖尿病患者和20例健康对照者。糖尿病患者根据尿白蛋白肌酐比值分为3组；20例正常白蛋白尿患者、20例微量白蛋白尿患者和20例大量白蛋白尿患者。对他们进行病史采集、全面临床检查、眼底检查、人体测量、尿中性粒细胞明胶酶相关脂质运载蛋白及尿白蛋白肌酐比值检测。
所有糖尿病组尿中性粒细胞明胶酶相关脂质运载蛋白均高于对照组，各糖尿病组之间无差异。当比较正常白蛋白尿组与对照组时差异有统计学意义，因为白蛋白肌酐比值无差异而尿中性粒细胞明胶酶相关脂质运载蛋白有统计学意义（5.94±1.85 ng/dl对1.96±0.65，p<0.001）。未发现与视网膜病变相关。
尿中性粒细胞明胶酶相关脂质运载蛋白是早期检测糖尿病肾病的敏感标志物，即使在正常白蛋白尿患者中也提示在微量白蛋白尿之前早期肾小管损伤。它与视网膜病变无关。
