Department of Pediatrics, Kanazawa Medical Center, National Hospital Organization, 1-1 Shimo-Ishibiki, Kanazawa, Ishikawa, 920-8650, Japan.
Department of Pediatrics, Kanazawa Medical University Hospital, Uchinada, Ishikawa, Japan.
Ir J Med Sci. 2023 Oct;192(5):2507-2511. doi: 10.1007/s11845-023-03296-8. Epub 2023 Feb 3.
Urinary levels of N-acetyl-β-D-glucosaminidase (NAG), α1-microglobulin (α1-MG), and β2-microglobulin (β2-MG) are measured as markers of renal tubular damage. We previously determined normal values for these urine biochemical examinations in healthy children over 3 years old. However, the values are not applicable to children younger than 2 years old, and children less than 1 year old, in particular, seem to show very high levels for all these markers. Hence, as normal values for children below 2 years old remain unclear, we determined the normal values for urinary biochemical markers in this age group.
Fresh urine samples were obtained from 293 healthy children (from newborns to 2-year-old children). All the samples were subjected to normal urinalysis. NAG, α1-MG, β2-MG, and creatinine (Cr) levels in extracted samples were measured immediately in the central laboratory at Kanazawa Medical Center.
The normal values for each biomarker in children below 2 years of age were determined. Additionally, urinary α1-MG levels were observed to decrease most rapidly with age, almost reaching the level at ≥ 3 years by 6 months after birth.
Renal tubular function can be evaluated in children < 3 years old using the normal values. Further, the most stable and useful urinary marker from early infancy seems to be urinary α1-MG.
尿 N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、α1-微球蛋白(α1-MG)和β2-微球蛋白(β2-MG)水平可作为肾小管损伤的标志物进行测量。我们之前确定了 3 岁以上健康儿童这些尿液生化检查的正常值。然而,这些值不适用于 2 岁以下的儿童,特别是 1 岁以下的儿童,这些标志物的水平似乎都非常高。因此,由于 2 岁以下儿童的正常值尚不清楚,我们确定了该年龄段尿生化标志物的正常值。
从 293 名健康儿童(新生儿至 2 岁儿童)中获得新鲜尿液样本。所有样本均进行常规尿液分析。在金泽医疗中心的中心实验室立即测量提取样本中的 NAG、α1-MG、β2-MG 和肌酐(Cr)水平。
确定了 2 岁以下儿童每个生物标志物的正常值。此外,观察到尿 α1-MG 水平随年龄下降最快,出生后 6 个月几乎达到≥3 岁的水平。
可以使用正常值评估<3 岁儿童的肾小管功能。此外,似乎从婴儿早期开始最稳定和有用的尿标志物是尿 α1-MG。