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Evaluation of N-acetyl-β-D-glucosaminidase as a prognostic marker for diabetic nephropathy in type 2 diabetics: systematic review and meta-analysis

  • Nephrology - Review
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Abstract

Objective

This review aimed to assess the utility of urinary N-acetyl-β-D-glucosaminidase (uNAG) as a prognostic biomarker for nephropathy in patients with type 2 diabetes mellitus.

Methods

The search for relevant studies was conducted across multiple databases, including PubMed (Medline), EMBASE, LILACS, CENTRAL, IBECS, and gray literature. We employed a random effects model to calculate the standardized mean difference and 95% confidence interval. Furthermore, we assessed heterogeneity using Cochrane's Q test and Higgins' I2 statistics.

Results

This review included a total of 16 articles involving 1669 patients, with 13 being case–control studies and three being cohorts. The meta-analysis conducted across all studies revealed significant heterogeneity. However, subgroup analysis of four studies indicated that an increase in uNAG among normoalbuminuric patients was associated with the development of macroalbuminuria (DMP = – 1.47; 95% CI = – 1.98 to 0.95; p < 0.00001; I2 = 45%). Conversely, it did not demonstrate effectiveness in predicting the development of microalbuminuria (DMP = 0.26; 95% CI = – 0.08 to 0.60; p = 0.13; I2 = 17%).

Conclusions

Elevated uNAG levels in normoalbuminuric patients may indicate an increased risk for the development of macroalbuminuria, but not microalbuminuria. However, the high heterogeneity observed among the studies highlights the necessity for further research to validate these findings.

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The authors declare that the research was conducted without any commercial or financial relationships.

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Authors and Affiliations

  1. Laboratory of Translational Biomedicine, University of Extremo Sul Catarinense, Criciúma, Santa Catarina, Brazil

    Augusto dos Santos Bitencourt, Régis Leães Vargas Filho, Gabriele da Silveira Prestes, Maria Laura Rodrigues Uggioni, Fernanda Marçal, Tamy Colonetti & Maria Inês da Rosa

  2. Rua Cruz e Souza, 510, Bairro Pio Correa, Criciúma, SC, 88811-550, Brazil

    Maria Inês da Rosa

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  1. Augusto dos Santos Bitencourt
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dos Santos Bitencourt, A., Vargas Filho, R.L., da Silveira Prestes, G. et al. Evaluation of N-acetyl-β-D-glucosaminidase as a prognostic marker for diabetic nephropathy in type 2 diabetics: systematic review and meta-analysis. Int Urol Nephrol 56, 1651–1661 (2024). https://doi.org/10.1007/s11255-023-03843-3

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