Kamianowska Monika, Szczepański Marek, Sawicka Ewa, Bebko Barbara, Wasilewska Anna
Department of Neonatology and Neonatal Intensive Care, Medical University of Bialystok, Bialystok, Poland.
Department of Paediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.
Arch Med Sci. 2020 May 18;20(3):762-768. doi: 10.5114/aoms.2020.95424. eCollection 2024.
Chronic kidney disease and end-stage renal disease have been found to be caused by diabetes. More recently, the renal tubulointerstitium has been increasingly assumed to play a role in the pathogenesis of diabetic nephropathy with prolonged exposure to a variety of metabolic and haemodynamic injuring factors associated with sustained hyperglycaemia as contributing factors. This study aimed to investigate whether maternal diabetes could be the factor affecting kidney function in a newborn with the use of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) - biomarkers of renal injury.
The study included 138 full-term newborns: 50 newborns from diabetic pregnancies and 88 healthy newborns. The concentrations of NGAL and KIM-1 were determined in urine in the first or the second day of life with a commercially available ELISA kit.
Considerably higher urine level of NGAL (25.7 (11.8-40.8)) and NGAL/cr. (29.1 (19.1-47.4)) in babies from diabetic pregnancies has been found when compared to the reference group (16.74 (9.9-27.5)) and (21.9 (14.6-29.8)) ( = 0.01, < 0.01) respectively. We also found a significantly higher urine level of NGAL (27.8 (13.6-44.2)), NGAL/cr. (31.9 (17.6-57.4)), and KIM-1/cr. (2.6 (1.6-5.5)) in babies of diabetic mothers treated with insulin when compared to the reference group (16.7 (9.9-27.5)), (21.9 (14.6-29.8)), (1.9 (0.8-3.2)), ( = 0.01, = 0.02, = 0.02), respectively.
Based on the results of this study, we indicate for the first time that maternal diabetes mellitus during pregnancy may be considered as the cause of tubular kidney damage in newborns.
慢性肾脏病和终末期肾病已被发现由糖尿病引起。最近，随着长期暴露于与持续性高血糖相关的多种代谢和血流动力学损伤因素，肾小管间质在糖尿病肾病发病机制中的作用越来越受到重视。本研究旨在通过使用中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和肾损伤分子-1（KIM-1）——肾损伤生物标志物，探讨母体糖尿病是否可能是影响新生儿肾功能的因素。
本研究纳入138例足月儿：50例来自糖尿病孕妇的新生儿和88例健康新生儿。在出生后第一天或第二天，使用市售酶联免疫吸附测定（ELISA）试剂盒测定尿液中NGAL和KIM-1的浓度。
与参照组（分别为16.74（9.9 - 27.5）和21.9（14.6 - 29.8））相比，糖尿病孕妇所生婴儿的尿液中NGAL水平（25.7（11.8 - 40.8））和NGAL/肌酐水平（29.1（19.1 - 47.4））显著更高（分别为P = 0.01，P < 0.01）。我们还发现，与参照组（分别为16.7（9.9 - 27.5）、21.9（14.6 - 29.8）、1.9（0.8 - 3.2））相比，接受胰岛素治疗的糖尿病母亲所生婴儿的尿液中NGAL水平（27.8（13.6 - 44.2））、NGAL/肌酐水平（31.9（17.6 - 57.4））和KIM-1/肌酐水平（2.6（1.6 - 5.5））显著更高（分别为P = 0.01，P = 0.02，P = 0.02）。
基于本研究结果，我们首次表明孕期母体糖尿病可能被视为新生儿肾小管损伤的原因。
