Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus
Objectives. As a screening index of diabetic kidney disease (DKD), urinary albumin/creatine ratio (UACR) is commonly used. However, approximately 23.3%-56.6% of DKD patients with estimated glomerular filtration rate eGFR<60 ml/min per 1.73 m2 are normoalbuminuric. Thus, urinary biomarkers of nona...
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Wiley
2019-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2019/5063089 |
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| author | Aimei Li Bin Yi Yan Liu Jianwen Wang Qing Dai Yuxi Huang Yan Chun Li Hao Zhang |
| author_facet | Aimei Li Bin Yi Yan Liu Jianwen Wang Qing Dai Yuxi Huang Yan Chun Li Hao Zhang |
| author_sort | Aimei Li |
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| description | Objectives. As a screening index of diabetic kidney disease (DKD), urinary albumin/creatine ratio (UACR) is commonly used. However, approximately 23.3%-56.6% of DKD patients with estimated glomerular filtration rate eGFR<60 ml/min per 1.73 m2 are normoalbuminuric. Thus, urinary biomarkers of nonalbuminuric renal insufficiency in type 2 diabetes mellitus (T2DM) patients are urgently needed. Methods. This cross-sectional study enrolled 209 T2DM patients with normoalbuminuria whose diabetes duration was more than 5 years. The patients were classified into two groups, NO-CKD (eGFR≥60 ml/min per 1.73 m2, n=165) and NA-DKD (eGFR<60 ml/min per 1.73 m2, n=44). Levels of urinary neutrophil gelatinase-associated lipocalin (NGAL), retinol-binding protein (RBP), plasminogen activator inhibitor-1 (PAI-1), vascular cell adhesion molecule-1 (VCAM-1), and E-cadherin were detected, and their correlations with eGFR, plasma TNF-α, IL-6, endothelin-1 (ET-1), and 8-hydroxydeoxyguanosine (8-OHdG) were assessed. Results. Among patients with renal insufficiency, 26.0% was normoalbuminuric. Compared to the NO-CKD group, the NA-DKD group was older with lower hemoglobin (HB) levels and higher systolic blood pressure (SBP), plasma TNF-α, IL-6, and 8-OHdG levels. Logistic regression analysis suggested that age, TNF-α, and 8-OHdG were independent risk factors for nonalbuminuric renal insufficiency. Compared to the NO-CKD group, the NA-DKD group exhibited significant increases in urinary NGAL and RBP levels but not PAI-1, VCAM-1, and E-cadherin. Urinary NGAL and RBP both correlated negatively with eGFR and positively with plasma IL-6 and 8-OHdG. Multiple linear regression indicated NGAL (β=−0.287, p=0.008) and RBP (β=−44.545, p<0.001) were independently correlated with eGFR. Conclusion. Age, plasma TNF-α, and 8-OHdG are independent risk factors for renal insufficiency in T2DM patients with normoalbuminuria. Urinary NGAL and RBP can serve as noninvasive biomarkers of normoalbuminuric renal insufficiency in T2DM. |
| format | Article |
| id | doaj-art-b937e33294c9424f8ddecb0ae9458e73 |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Journal of Immunology Research |
| spelling | doaj-art-b937e33294c9424f8ddecb0ae9458e732025-02-03T06:42:08ZengWileyJournal of Immunology Research2314-88612314-71562019-01-01201910.1155/2019/50630895063089Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes MellitusAimei Li0Bin Yi1Yan Liu2Jianwen Wang3Qing Dai4Yuxi Huang5Yan Chun Li6Hao Zhang7Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaDepartment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaDepartment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaDepartment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaDepartment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaDepartment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaDepartment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaDepartment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, 410013 Hunan, ChinaObjectives. As a screening index of diabetic kidney disease (DKD), urinary albumin/creatine ratio (UACR) is commonly used. However, approximately 23.3%-56.6% of DKD patients with estimated glomerular filtration rate eGFR<60 ml/min per 1.73 m2 are normoalbuminuric. Thus, urinary biomarkers of nonalbuminuric renal insufficiency in type 2 diabetes mellitus (T2DM) patients are urgently needed. Methods. This cross-sectional study enrolled 209 T2DM patients with normoalbuminuria whose diabetes duration was more than 5 years. The patients were classified into two groups, NO-CKD (eGFR≥60 ml/min per 1.73 m2, n=165) and NA-DKD (eGFR<60 ml/min per 1.73 m2, n=44). Levels of urinary neutrophil gelatinase-associated lipocalin (NGAL), retinol-binding protein (RBP), plasminogen activator inhibitor-1 (PAI-1), vascular cell adhesion molecule-1 (VCAM-1), and E-cadherin were detected, and their correlations with eGFR, plasma TNF-α, IL-6, endothelin-1 (ET-1), and 8-hydroxydeoxyguanosine (8-OHdG) were assessed. Results. Among patients with renal insufficiency, 26.0% was normoalbuminuric. Compared to the NO-CKD group, the NA-DKD group was older with lower hemoglobin (HB) levels and higher systolic blood pressure (SBP), plasma TNF-α, IL-6, and 8-OHdG levels. Logistic regression analysis suggested that age, TNF-α, and 8-OHdG were independent risk factors for nonalbuminuric renal insufficiency. Compared to the NO-CKD group, the NA-DKD group exhibited significant increases in urinary NGAL and RBP levels but not PAI-1, VCAM-1, and E-cadherin. Urinary NGAL and RBP both correlated negatively with eGFR and positively with plasma IL-6 and 8-OHdG. Multiple linear regression indicated NGAL (β=−0.287, p=0.008) and RBP (β=−44.545, p<0.001) were independently correlated with eGFR. Conclusion. Age, plasma TNF-α, and 8-OHdG are independent risk factors for renal insufficiency in T2DM patients with normoalbuminuria. Urinary NGAL and RBP can serve as noninvasive biomarkers of normoalbuminuric renal insufficiency in T2DM.http://dx.doi.org/10.1155/2019/5063089 |
| spellingShingle | Aimei Li Bin Yi Yan Liu Jianwen Wang Qing Dai Yuxi Huang Yan Chun Li Hao Zhang Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus Journal of Immunology Research |
| title | Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus |
| title_full | Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus |
| title_fullStr | Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus |
| title_full_unstemmed | Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus |
| title_short | Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus |
| title_sort | urinary ngal and rbp are biomarkers of normoalbuminuric renal insufficiency in type 2 diabetes mellitus |
| url | http://dx.doi.org/10.1155/2019/5063089 |
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