Division of Endocrinology and Metabolism, Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
J Diabetes Complications. 2018 Aug;32(8):777-783. doi: 10.1016/j.jdiacomp.2018.05.019. Epub 2018 Jun 1.
Recent evidence has shown that renal tubulointerstitial injuries play an important role in diabetic nephropathy. In this study, we evaluated the association between urinary N-acetyl-β-d-glucosaminidase (uNAG), an early renal tubular damage marker, and carotid artery atherosclerosis in patients with type 1 diabetes (T1D).
This was a cross-sectional study of 88 patients with T1D. Demographic and laboratory data; urinary indices, including urinary NAG-to-creatinine ratio (uNCR), and albumin-to-creatinine ratio (uACR); and carotid ultrasonography were investigated.
Eighty-eight subjects were divided into three groups based on uNCR tertiles. Subjects belonging to the highest tertile of uNCR had the highest average mean and maximum carotid intima-media thickness (IMT). An elevated uNCR was also significantly correlated with increased average mean and maximum carotid IMT, whereas an elevated uACR was not. Even after adjusting for confounding factors, uNCR continued to be a meaningful predictive marker for increased average mean and maximum IMT. Conversely, the uACR could not predict carotid IMT after adjustment for confounding factors.
Elevated levels of uNAG are significantly associated with carotid artery atherosclerosis in patients with T1D independently of albuminuria, a marker of glomerular damage.
最近的证据表明，肾小管间质损伤在糖尿病肾病中起着重要作用。在这项研究中，我们评估了尿 N-乙酰-β-D-氨基葡萄糖苷酶（uNAG），一种早期肾小管损伤标志物，与 1 型糖尿病（T1D）患者颈动脉粥样硬化之间的关系。
这是一项横断面研究，共纳入 88 例 T1D 患者。研究调查了患者的人口统计学和实验室数据、尿指标，包括尿 NAG 与肌酐比值（uNCR）和尿白蛋白与肌酐比值（uACR）以及颈动脉超声。
88 名受试者根据 uNCR 三分位值分为三组。uNCR 最高三分位组的受试者颈动脉内膜中层厚度（IMT）的平均值和最大值最高。升高的 uNCR 与平均颈动脉 IMT 增加显著相关，而升高的 uACR 则没有。即使在调整混杂因素后，uNCR 仍然是平均颈动脉 IMT 增加的有意义的预测标志物。相反，在调整混杂因素后，uACR 不能预测颈动脉 IMT。
在 1 型糖尿病患者中，uNAG 水平升高与颈动脉粥样硬化显著相关，与肾小球损伤的标志物尿白蛋白无关。
