Circadian rhythm in urinary N-acetyl-beta-glucosaminidase (NAG) of clinically healthy subjects. Timing and phase relation to other urinary circadian rhythms.

Urinary N-acetyl-beta-glucosaminidase (NAG), a lysosomal enzyme of renal tubular origin, has been shown to be a sensitive indicator of renal tubular function. This study documents a circadian rhythm in the urinary activity of NAG, statistically validated and quantified by the cosinor method, in 19 female and 15 male human subjects. The acrophase of the circadian rhythm in urinary NAG activity occurs at 09(40) with 95% confidence limits between 08(40) and 12(08) and is similar to the timing of the circadian rhythm in urinary free cortisol. The circadian acrophase of urinary NAG activity lags in timing the circadian rhythms in urine volume, Na and K excretion, and urinary free adrenalin and noradrenalin, by about five to ten hours and the circadian rhythm in creatinine excretion by about 11 hours. These functions with their characteristic phase relations are part of the internal circadian time structure of the human organism, and may provide internal phase references, independent of the "time of day." This study also documents a sex difference in mesor of the circadian rhythms in urinary NAG activity, with female subjects having a higher mesor and amplitude than the male subjects, and in the excretion of creatinine and potassium, with male subjects having a higher mesor and amplitude than the female subjects.