title: Urinary leucine aminopeptidase is a more sensitive indicator of early renal damage in non-insulin-dependent diabetics than microalbuminuria.
abstract: We measured urinary activity of leucine aminopeptidase (EC 3.4.11.2) and creatinine concentrations (Cr, in mmol) in samples of second morning urine from 25 healthy subjects and 59 non-insulin-dependent diabetic (NIDD) subjects. If NIDD subjects are grouped according to their Alb/Cr ratio into normoalbuminuria (group A, Alb/Cr < 2.8 mg/mmol), microalbuminuria (group B, Alb/Cr 2.8-26.8 mg/mmol), and macroalbuminuria (group C, Alb/Cr > 26.8 mg/mmol), LAP/Cr ratios in all three groups exceeded those for healthy age-matched controls. Moreover, this ratio was higher in group B than in group A. The value for LAP/Cr was clearly abnormal (i.e., exceeded the upper limit of normal, log normal + 2 SD, found in healthy subjects) in 44% of group A. In the first 10-year period Of NIDD, prevalance of abnormal LAP/Cr ratio was 61.3%, whereas that of microalbuminuria was 35.5%. We have also found a LAP/Cr ratio abnormality of 91% in group B. Evidently, LAP/Cr may be increased early in NIDD subjects and be a more sensitive predictor of incipient nephropathy than microalbuminuria.
authors.affiliation: Department of Biochemistry, Medical Faculty of Ondokuz Mayis University, Samsun, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Bedir
authors.forename: I C
authors.initials: IC
authors.lastname: Ozener
authors.forename: K
authors.initials: K
authors.lastname: Emerk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000652:urine*; D015415:Biomarkers; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000201:enzymology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007687:Kidney Tubules, Proximal / Q000201:enzymology / Q000503:physiopathology; D007931:Leucyl Aminopeptidase / Q000652:urine*; D008297:Male; D008871:Microvilli / Q000201:enzymology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007931:Leucyl Aminopeptidase