[Clinical significance of urinary enzymes in diabetes mellitus].
The aim of this study was to clarify the clinical significance of urinary enzyme activity in patients with diabetes mellitus. Patients were divided into two groups: group A - 102 outpatients, group B-23 inpatients. Spot urine samples before breakfast from group A and aliquots of 24-hours urine collections at 4 degrees C from group B were used. Urinary enzyme activities (N-acetyl- beta-D-glucosaminidase: NAG, alkaline phosphatase: ALP, leucine aminopeptidase: LAP, gamma-glutamyl transpeptidase: gamma-GTP) were determined by spectrophotometric assay, rate assay, Tuppy method and Orlowski method, respectively. 1) In group A, the percentage of the cases which showed higher than the normal range (NAG: 1.3-8.7, ALP: 4.2-17.7, LAP: 0-22.9 U/g. cer.) was 42.2% in NAG, 21.6% in ALP, and 8.8% in LAP. In a multiple regression analysis, the predictor variables which contributed to NAG were HbA1c, age, urinary protein and the one that contributed to ALP, LAP, gamma-GTP was urinary beta 2-microglobulin. 2) In group B, 87% of NAG was above the normal range (Mean +/- 2 SD; 4.8 +/- 3.9 U/day). There was no difference in the NAG activity between patients with and without nephropathy. The percent of high activities of ALP, LAP and gamma-GTP were 17%, 17%, 4%, respectively. Most of them were patients with nephropathy. There were correlations among ALP, LAP and gamma-GTP, though no correlation existed between NAG and the other three enzymes. These results suggested: 1) NAG reflects lysosomal dysfunction of both glomerular and proximal tubular epithelial cells which may be caused by poor glycemic control.(ABSTRACT TRUNCATED AT 250 WORDS)
Morita
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First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Kaizu
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Uriu
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Eto
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D000118:Acetylglucosaminidase / Q000652:urine*; D000368:Aged; D000469:Alkaline Phosphatase / Q000652:urine; D004796:Clinical Enzyme Tests; D003920:Diabetes Mellitus / Q000201:enzymology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000175:diagnosis; D005260:Female; D006596:Hexosaminidases / Q000652:urine*; D006801:Humans; D007931:Leucyl Aminopeptidase / Q000652:urine; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D005723:gamma-Glutamyltransferase / Q000652:urine
D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D006596:Hexosaminidases; D000118:Acetylglucosaminidase; D007931:Leucyl Aminopeptidase