1 型糖尿病患儿尿液生物标志物 NGAL 和β2-微球蛋白。

Urinary biomarkers NG AL and beta-2 microglobulin in children with type 1 diabetes mellitus.

机构信息

Department of Pediatrics, 28862 Maulana Azad Medical College and Lok Nayak Hospital , New Delhi, India.

Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

出版信息

J Pediatr Endocrinol Metab. 2024 Aug 20;37(9):764-772. doi: 10.1515/jpem-2024-0172. Print 2024 Sep 25.

DOI:10.1515/jpem-2024-0172

PMID:39166792

Abstract

OBJECTIVES

To study the urinary neutrophil gelatinase-associated lipocalin (NGAL) and beta-2-microglobulin (β2M) levels as markers of tubular damage in children with type 1 diabetes (T1DM).

METHODS

Forty T1DM children and 40 age-matched controls were enrolled. Subjects with coexisting kidney disorder, intake of oral glucose lowering drugs and syndromic diabetes mellitus were excluded. Fasting plasma glucose, glycated hemoglobin (HbA), kidney function, urinary albumin-creatinine ratio (UACR), NGAL and β2M were measured and compared in cases and controls.

RESULTS

The median (IQR) age of cases and controls was 10.6 (8, 14.2) and 10.7 (8.4, 13.7) years, respectively. Cases had disease duration of 4 (3, 6.8) years and HbA 10.9 (9, 13.1) %. Microalbuminuria was seen in 14 (35 %). Median (IQR) levels of UACR were higher in cases than controls [19.38 (10.27, 35.26) and 6.49 (3.10, 11.65) µg/mg; p<0.001], similarly NGAL/creatinine [352.21 (191.49, 572.45) and 190.54 (125.91, 322.83) ng/mg; p=0.006], unlike β2M/creatinine [1.7 (0.43, 6.02) and 2.12 (1.05, 4.47) µg/mg; p=0.637]. Children with higher HbA (≥10 %) had higher urinary ACR and tubular biomarkers than HbA<10 % (p>0.05). Urinary ACR showed positive correlation with NGAL/creatinine (r=0.38, p=0.019) and β2M/creatinine (r=0.42, p=0.009).

CONCLUSIONS

Urinary biomarkers NGAL and β2M were elevated in the presence of normal urinary microalbumin levels suggestive of early tubular damage in T1DM.

摘要

目的

研究中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和β2-微球蛋白（β2M）作为 1 型糖尿病（T1DM）患儿肾小管损伤标志物的水平。

方法

纳入 40 例 T1DM 患儿和 40 名年龄匹配的对照者。排除同时存在肾脏疾病、服用口服降糖药物和综合征性糖尿病的患者。测量并比较病例组和对照组的空腹血糖、糖化血红蛋白（HbA）、肾功能、尿白蛋白/肌酐比值（UACR）、NGAL 和β2M。

结果

病例组和对照组的中位（IQR）年龄分别为 10.6（8，14.2）和 10.7（8.4，13.7）岁。病例组的病程为 4（3，6.8）年，HbA 为 10.9（9，13.1）%。14 例（35%）患儿存在微量白蛋白尿。病例组 UACR 中位数（IQR）高于对照组[19.38（10.27，35.26）和 6.49（3.10，11.65）μg/mg；p<0.001]，NGAL/肌酐中位数（IQR）也高于对照组[352.21（191.49，572.45）和 190.54（125.91，322.83）ng/mg；p=0.006]，但β2M/肌酐中位数（IQR）差异无统计学意义[1.7（0.43，6.02）和 2.12（1.05，4.47）μg/mg；p=0.637]。HbA 水平≥10%（n=17）的患儿尿 ACR 和肾小管生物标志物均高于 HbA<10%（n=23）（p>0.05）。尿 ACR 与 NGAL/肌酐（r=0.38，p=0.019）和β2M/肌酐（r=0.42，p=0.009）呈正相关。