INTRODUCTION: Diabetic nephropathy is a major cause of morbidity and mortality among young adults with type 1 diabetes mellitus (DM). Albuminuria, the gold standard for early diagnosis, cannot always detect early diabetic nephropathy. We aimed at evaluating the level of urine neutrophil gelatinase-associated lipocalin (NGAL) as a marker of tubulointerstitial damage in children and adolescents with type 1 DM in relation to the level of albuminuria and other parameters. MATERIALS AND METHODS: Fifty children with type 1 DM for more than 5 years were included in this study (mean age, 13.8 ± 4.0 years), and 18 healthy children served as controls. Patients with overt albuminuria (> 300 mg/g creatinine) or inflammatory states were excluded. Urine NGAL, microalbuminuria, and urine albumin-creatinine ratio were measured in patients and controls as well as other parameters. RESULTS: Urine NGAL was significantly higher in microalbuminuric in comparison with normoalbuminuric patients and controls, and correlated positively with urine albumin-creatinine ratio. A positive urine NGAL was observed in 12 of 38 normoalbuminuric patients (31.6%) compared to 9 of 12 microalbuminuric patients (75%). A positive correlation was reported between urine NGAL and both Hemoglobin A1c and duration of DM, but not with estimated glomerular filtration rate or hypertension. CONCLUSIONS: Diabetic children, even some normoalbuminurics, showed increased urine NGAL. This finding may support the hypothesis of a "tubular phase" of diabetic disease preceding overt diabetic nephropathy, and hence, the use of urine NGAL measurement for early evaluation of renal involvement.
INTRODUCTION:Diabetic nephropathy is a major cause of morbidity and mortality among young adults with type 1 diabetes mellitus (DM). Albuminuria, the gold standard for early diagnosis, cannot always detect early diabetic nephropathy. We aimed at evaluating the level of urine neutrophil gelatinase-associated lipocalin (NGAL) as a marker of tubulointerstitial damage in children and adolescents with type 1 DM in relation to the level of albuminuria and other parameters. MATERIALS AND METHODS: Fifty children with type 1 DM for more than 5 years were included in this study (mean age, 13.8 ± 4.0 years), and 18 healthy children served as controls. Patients with overt albuminuria (> 300 mg/g creatinine) or inflammatory states were excluded. Urine NGAL, microalbuminuria, and urine albumin-creatinine ratio were measured in patients and controls as well as other parameters. RESULTS: Urine NGAL was significantly higher in microalbuminuric in comparison with normoalbuminuric patients and controls, and correlated positively with urine albumin-creatinine ratio. A positive urine NGAL was observed in 12 of 38 normoalbuminuric patients (31.6%) compared to 9 of 12 microalbuminuric patients (75%). A positive correlation was reported between urine NGAL and both Hemoglobin A1c and duration of DM, but not with estimated glomerular filtration rate or hypertension. CONCLUSIONS:Diabeticchildren, even some normoalbuminurics, showed increased urine NGAL. This finding may support the hypothesis of a "tubular phase" of diabetic disease preceding overt diabetic nephropathy, and hence, the use of urine NGAL measurement for early evaluation of renal involvement.
Authors: Federica Piani; Isabella Melena; Cameron Severn; Linh T Chung; Carissa Vinovskis; David Cherney; Laura Pyle; Carlos A Roncal-Jimenez; Miguel A Lanaspa; Arleta Rewers; Daniël H van Raalte; Wassim Obeid; Chirag Parikh; Robert G Nelson; Meda E Pavkov; Kristen J Nadeau; Richard J Johnson; Petter Bjornstad Journal: Pediatr Diabetes Date: 2021-09-06 Impact factor: 4.866
Authors: Isabella Melena; Federica Piani; Kalie L Tommerdahl; Cameron Severn; Linh T Chung; Alexis MacDonald; Carissa Vinovskis; David Cherney; Laura Pyle; Carlos A Roncal-Jimenez; Miguel A Lanaspa; Arleta Rewers; Daniël H van Raalte; Gabriel Cara-Fuentes; Chirag R Parikh; Robert G Nelson; Meda E Pavkov; Kristen J Nadeau; Richard J Johnson; Petter Bjornstad Journal: J Diabetes Complications Date: 2022-04-28 Impact factor: 3.219
Authors: Clare B Kelly; Michelle B Hookham; Jeremy Y Yu; Alicia J Jenkins; Alison J Nankervis; Kristian F Hanssen; Satish K Garg; James A Scardo; Samar M Hammad; M Kathryn Menard; Christopher E Aston; Timothy J Lyons Journal: Diabetes Care Date: 2017-11-09 Impact factor: 19.112