Application of urinary neutrophil gelatinase-associated lipocalin/creatinine ratio in early diagnosis and severity assessment of renal injury in patients with type 2 diabetes mellitus

doi:10.16150/j.1671-2870.2019.01.012

Abstract

Abstract:

Objective: To investigate the application of urinary neutrophil gelatinase associated lipocalin (NGAL)/creatinineratio in the early diagnosis and assessment of severity of renal injury in patients with type 2 diabetes mellitus (T2DM). Methods: A group of 112 T2DM patients were recruited. Based on urinary albumin/creatinine ratio (UACR), diabetic patients were divided into three groups: 38 cases with normal albuminuria (NA group), 36 cases with minimal albuminuria (MA group) and 38 cases with clinical albuminuria (CA group). And, 32 healthy subjects were served as controls (NC group). Urinary NGAL/creatinine ratio was calculated and compared among the groups and their correlations with other clinical parameters were analyzed. Results: Urinary NGAL/creatinine ratio in T2DM groups [NA, 16.46(6.94-27.07) ng/mg;MA, 20.16(6.76-44.35) ng/mg;CA, 26.89(10.60-56.94) ng/mg] was markedly increased than that in the normal control group [9.13(3.92-17.36) ng/mg] (P<0.05). In the T2DM groups, urinary NGAL/creatinine ratio in CA group was significantly higher than that in NA group (P<0.05). Correlation analysis showed that urinary NGAL/creatinine ratio was positively correlated with UACR, duration of diabetes and glycated hemoglobin (HbA1c) (P<0.05). Conclusions: Urinary NGAL could be an earlier marker than minimal albuminuria for detecting renal injury in T2DM. Furthermore, urinary NGAL level can evaluate the severity of renal injury.

Key words: Urinary neutrophil gelatinase-associated lipocalin, Urinary neutrophil gelatinase-associated lipocalin/creatinine ratio, Type 2 diabetic nephropathy

CLC Number:

R587.1

DENG Lin, DING Yi, WANG Ping, BIAN Bingxian, SHEN Lisong. Application of urinary neutrophil gelatinase-associated lipocalin/creatinine ratio in early diagnosis and severity assessment of renal injury in patients with type 2 diabetes mellitus[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(1): 61-65.

Figures/Tables 4

References 15

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项目	正常对照组（n=32）	2型糖尿病组			P值
项目	正常对照组（n=32）	NA组（n=38）	MA组（n=36）	CA组（n=38）	P值
性别 (男/女)	16/16	22/16	20/16	24/14	0.736
年龄 (岁)	54.47±6.66	55.39±8.86	58.36±7.77	57.97±9.41	0.140
高血压史（%）	0	23.72^a)	52.86^a),b)	71.13^a),b)	<0.001
冠心病史（%）	0	0	0	21.12^a),b),c)	<0.001
吸烟史（%）	21.92	26.34	27.82	28.91	0.919
体质量指数 (kg/m²)	24.15±2.74	24.17±3.69	25.35±3.72	26.50±3.58^a),b)	0.012
病程(年)	-	6.60±6.04^a)	10.34±7.07^a),b)	10.59±7.93^a),b)	<0.001
空腹血糖 (mmol/L)	5.26±0.38	7.93±3.05^a)	7.92±3.01^a)	8.38±3.08^a)	<0.001
HbA1c (%)	5.54±0.23	8.03±1.57^a)	8.80±1.81^a),b)	8.77±2.04^a),b)	<0.001
血肌酐 (μmol/L)	62.13±12.34	54.00±10.00^a)	54.58±13.73^a)	78.37±29.70^a),b),c)	<0.001
尿酸 (μmol/L)	267.25±74.29	300.55±104.54	306.61±83.15	356.16±82.23^a),b),c)	0.001
eGFR[mL/(min·1.73 m²)]	103.74±9.63	108.40±9.68	105.73±10.27	88.15±24.95^a),b),c)	<0.001
UACR(mg/g)	5.84(4.85~8.73)	12.69(8.69~20.81)	98.03(66.67~166.96)^a),b)	648.86(383.62~1765.89)^a),b),c)	<0.001

指标	正常对照组 (n=32)	2型糖尿病组			P值
指标	正常对照组 (n=32)	NA组(n=38)	MA组(n=36)	CA组(n=38)	P值
尿NGAL/肌酐比值 (ng/mg)	9.13(3.92~17.36)	16.46(6.94~27.07)^a)	20.16(6.76~44.35)^a)	26.89(10.60~56.94)^a),b)	0.001

指标	相关系数r值	P值
UACR	0.355	<0.001
体质量指数	-0.094	0.261
收缩压	0.111	0.184
病程	0.259	0.002
空腹血糖	0.148	0.077
HbA1c	0.305	<0.001
血肌酐	-0.119	0.156
尿素氮	-0.030	0.717
尿酸	-0.048	0.569
eGFR	-0.134	0.109