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Endocrine

, Volume 41, Issue 1, pp 82–88 | Cite as

Urinary tubular biomarkers in short-term type 2 diabetes mellitus patients: a cross-sectional study

  • Wen-jin Fu
  • Shi-long Xiong
  • Yao-gao Fang
  • Shu Wen
  • Mei-lian Chen
  • Ren-tang Deng
  • Lei Zheng
  • Shao-bo Wang
  • Lan-fen Pen
  • Qian Wang
Original Article

Abstract

The purpose of this study was to investigate the prevalence of tubular damage in short-term (less than five years) type 2 diabetes mellitus (T2DM) patients and to explore the correlation between tubular markers and their relationship with renal indices at different stages of diabetic nephropathy. A group of 101 short-term T2DM patients and 28 control subjects were recruited. Tubular markers, such as neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-d-glucosaminidase (NAG), and kidney injury molecule 1 (KIM-1), as well as urinary albumin excretion were measured in voided urine. Glomerular filtration rate (GFR) was estimated via Macisaac’s formula. The patients were further categorized into three groups, namely, the normoalbuminuria, microalbuminuria, and macroalbuminuria groups, according to their urine albumin/creatinine ratio (UACR). Urinary tubular markers were compared and their correlations with renal indices [UACR and estimated GFR (eGFR)] were analyzed among the different diabetic groups. Compared with the control group, Urinary NGAL [median (IQR)][83.6(41.4−138.7) μg/gcr vs. 32.9(26.1−64.5) μg/gcr], NAG [13.5(8.7−17.9) U/gcr vs. 7.6(6.5−13.0) U/gcr] and KIM-1 [120.0(98.4−139.9) ng/gcr vs. 103.1(86.8−106.2) ng/gcr] in the T2DM were all markedly increased. For all patients, urinary NGAL had stronger positive correlations with UACR than NAG (R = 0.556 vs. 0.305, both P < 0.05). In addition, only urinary NGAL showed a negative correlation with eGFR (R = −0.215, P < 0.05). Urinary KIM-1, however, showed no significant difference among the three T2DM groups and did not correlate with either UACR or eGFR. As UACR increased from the normoalbuminuria to the last macroalbuminuria group, all of the markers increased. However, only the concentrations of NGAL were statistically different among the three diabetic groups. The correlation between the tubular markers and their relationships with the renal indices differed markedly among the three T2DM groups. In conclusion, these results suggest that tubular damage is common in short-term T2DM patients. Urinary NGAL may be a promising early marker for monitoring renal impairment in short-term T2DM patients.

Keywords

Tubular markers Type 2 diabetes mellitus Diabetic nephropathy Microalbuminuria 

Notes

Acknowledgments

This study was supported by the funds from the Scientific and Technological Projects of Dongguan city (200910515000104), Guangdong province, china, P. R.

Conflict of interest

Nothing to declare.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Wen-jin Fu
    • 1
    • 2
  • Shi-long Xiong
    • 2
  • Yao-gao Fang
    • 1
  • Shu Wen
    • 3
  • Mei-lian Chen
    • 1
  • Ren-tang Deng
    • 1
  • Lei Zheng
    • 2
  • Shao-bo Wang
    • 4
  • Lan-fen Pen
    • 1
  • Qian Wang
    • 2
  1. 1.Department of Laboratory, Affiliated Houjie HospitalGuangdong Medical CollegeDongguanChina
  2. 2.Department of Laboratory Medicine CentreSouthern Medical UniversityGuangzhouChina
  3. 3.Department of Obstetrics and Gynecology, Molecular and Human GeneticsBaylor College of MedicineHoustonUSA
  4. 4.Department of Endocrinology, Affiliated Houjie HospitalGuangdong Medical CollegeDongguanChina

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