Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan.
Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan.
J Nephrol. 2022 Jan;35(1):201-210. doi: 10.1007/s40620-021-00995-2. Epub 2021 Mar 1.
A urinary biomarker sensitive to glomerular functional or structural changes in diabetic kidney disease is required. This study examined whether urinary C-megalin reflects renal function or albuminuria in diabetes.
This was a cross-sectional study involving 1576 patients with type 1 or 2 diabetes. The exposure variables were estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR), and the outcomes were urinary C-megalin excretion and concentration. Two-part models were used to examine the associations between eGFR and UACR with urinary C-megalin excretion or concentration.
The UACR was linearly associated with urinary C-megalin excretion (per 100 mg/gCr of UACR; 11.8 fM/gCr [95% CI 8.9-14.7]). There was no association between decreasing eGFR and increasing urinary C-megalin excretion. The UACR was also linearly associated with the urinary C-megalin concentration (per 100 mg/gCr of UACR, 7.7 fM/L [95% CI 5.8-9.6]). At eGFR values > 60 mL/min/1.73 m, the eGFR and urinary C-megalin concentration were inversely linearly related (per 10 mL/min/1.73 m decline, 7.7 fM/L [95% CI 0.2-15.1]).
Urinary C-megalin excretion as well as concentration levels are potentially useful biomarkers to detect early changes in diabetic kidney disease.
需要一种对糖尿病肾病肾小球功能或结构变化敏感的尿生物标志物。本研究旨在探讨尿 C-megalin 是否反映糖尿病患者的肾功能或白蛋白尿。
这是一项涉及 1576 例 1 型或 2 型糖尿病患者的横断面研究。暴露变量为估算肾小球滤过率（eGFR）和尿白蛋白与肌酐比值（UACR），结局变量为尿 C-megalin 排泄率和浓度。采用两部分模型分析 eGFR 和 UACR 与尿 C-megalin 排泄率或浓度之间的关系。
UACR 与尿 C-megalin 排泄率呈线性相关（每 100mg/gCr 的 UACR，增加 11.8fM/gCr[95%CI 8.9-14.7]）。随着 eGFR 的降低，尿 C-megalin 排泄率没有增加。UACR 与尿 C-megalin 浓度也呈线性相关（每 100mg/gCr 的 UACR，增加 7.7fM/L[95%CI 5.8-9.6]）。在 eGFR 值>60mL/min/1.73m 时，eGFR 与尿 C-megalin 浓度呈负相关（每 10mL/min/1.73m 下降，增加 7.7fM/L[95%CI 0.2-15.1]）。
尿 C-megalin 排泄率和浓度可能是检测糖尿病肾病早期变化的有用生物标志物。
