José Antonio M de Carvalho1, Etiane Tatsch2, Bruna S Hausen2, Yãnaí S Bollick3, Maria B Moretto4, Thiago Duarte5, Marta M M F Duarte6, Sílvia W K Londero7, Melissa O Premaor8, Fabio V Comim8, Joris R Delanghe9, Rafael N Moresco10. 1. Laboratory of Clinical Biochemistry, Department of Clinical and Toxicological Analysis, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; University Hospital, Santa Maria, RS, Brazil; Pharmaceutical Sciences Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. 2. Laboratory of Clinical Biochemistry, Department of Clinical and Toxicological Analysis, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Pharmaceutical Sciences Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. 3. Laboratory of Clinical Biochemistry, Department of Clinical and Toxicological Analysis, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. 4. Pharmaceutical Sciences Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Pharmacology Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. 5. Pharmacology Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. 6. Pharmacology Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Department of Health Sciences, Universidade Luterana do Brasil, Santa Maria, RS, Brazil. 7. University Hospital, Santa Maria, RS, Brazil. 8. Pharmacology Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Department of Clinical Medicine, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. 9. Department of Clinical Chemistry, Ghent University Hospital, Gent, Belgium. 10. Laboratory of Clinical Biochemistry, Department of Clinical and Toxicological Analysis, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Pharmaceutical Sciences Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Pharmacology Postgraduate Program, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil. Electronic address: rnmoresco@ufsm.br.
Abstract
OBJECTIVES: Renal dysfunction has been reported in normoalbuminuric patients, demonstrating the necessity to improve the diagnostic and prognostic tools for diabetic kidney disease (DKD) investigation. Therefore, the aim of this study was to investigate whether the urinary levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) are increased in type 2 diabetes mellitus (DM) patients with normal or mildly increased albuminuria. DESIGN AND METHODS: In this study, 117 type 2 DM patients classified into three groups according to urinary albumin/creatinine ratio (uACR): uACR<10mg/g creatinine, uACR 10-30mg/g creatinine and uACR>30mg/g creatinine were enrolled. Urinary concentrations of KIM-1 (uKIM-1) and NGAL (uNGAL) were measured. RESULTS: uKIM-1 levels increased progressively from uACR<10mg/g creatinine (69.0±20.8pg/ml) to uACR 10-30mg/g creatinine (106.1±41.2pg/ml) and to uACR>30mg/g creatinine (166.0±31.9pg/ml) (P<0.001). In addition, uNGAL levels increased progressively from uACR<10mg/g creatinine (29.5±8.8ng/ml) to uACR 10-30mg/g creatinine (51.7±10.9ng/ml) and to uACR>30mg/g creatinine (71.0±9.6ng/ml) (P<0.001) patients. Similarly, both uKIM-1 and uNGAL adjusted by urinary creatinine were increased in patients with uACR 10-30mg/g creatinine. Significant and positive correlations were observed between uACR, uKIM-1 and uNGAL. CONCLUSIONS: uKIM-1 and uNGAL were increased in type 2 DM patients with normal or mildly increased albuminuria, which indicates that tubular and glomerular injuries may be occurring even at the earliest stage of DKD.
OBJECTIVES:Renal dysfunction has been reported in normoalbuminuric patients, demonstrating the necessity to improve the diagnostic and prognostic tools for diabetic kidney disease (DKD) investigation. Therefore, the aim of this study was to investigate whether the urinary levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) are increased in type 2 diabetes mellitus (DM) patients with normal or mildly increased albuminuria. DESIGN AND METHODS: In this study, 117 type 2 DMpatients classified into three groups according to urinary albumin/creatinine ratio (uACR): uACR<10mg/g creatinine, uACR 10-30mg/g creatinine and uACR>30mg/g creatinine were enrolled. Urinary concentrations of KIM-1 (uKIM-1) and NGAL (uNGAL) were measured. RESULTS: uKIM-1 levels increased progressively from uACR<10mg/g creatinine (69.0±20.8pg/ml) to uACR 10-30mg/g creatinine (106.1±41.2pg/ml) and to uACR>30mg/g creatinine (166.0±31.9pg/ml) (P<0.001). In addition, uNGAL levels increased progressively from uACR<10mg/g creatinine (29.5±8.8ng/ml) to uACR 10-30mg/g creatinine (51.7±10.9ng/ml) and to uACR>30mg/g creatinine (71.0±9.6ng/ml) (P<0.001) patients. Similarly, both uKIM-1 and uNGAL adjusted by urinary creatinine were increased in patients with uACR 10-30mg/g creatinine. Significant and positive correlations were observed between uACR, uKIM-1 and uNGAL. CONCLUSIONS: uKIM-1 and uNGAL were increased in type 2 DMpatients with normal or mildly increased albuminuria, which indicates that tubular and glomerular injuries may be occurring even at the earliest stage of DKD.
Authors: Moon Bae Ahn; Kyoung Soon Cho; Seul Ki Kim; Shin Hee Kim; Won Kyoung Cho; Min Ho Jung; Jin-Soon Suh; Byung-Kyu Suh Journal: Children (Basel) Date: 2021-05-19