Neutrophil gelatinase-associated lipocalin as an early biomarker of nephropathy in diabetic patients.
OBJECTIVE
Renal tubulointerstitium plays an important role in the development and progression of diabetic nephropathy.


METHODS
With the present study, we aimed at evaluating the levels of neutrophil gelatinase-associated lipocalin (NGAL), a tubular stress protein, in serum (sNGAL) and urine (uNGAL) from a cohort of 56 patients with type 2 diabetes mellitus categorized into three groups (normoalbuminuria, microalbuminuria and diabetic nephropathy).


RESULTS
All groups showed increased NGAL values with respect to controls; interestingly, increased NGAL levels were already found in diabetic patients without early signs of glomerular damage (normoalbuminuric). Both sNGAL and uNGAL increased in parallel with the severity of renal disease, reaching higher levels in patients with manifest diabetic nephropathy. The assessment of Pearson coefficient evidenced significant relationships between sNGAL and, respectively, uNGAL, serum creatinine and GFR (inversely) and between uNGAL and, respectively, serum creatinine, proteinuria, albuminuria, serum albumin and GFR (both inversely).


CONCLUSIONS
NGAL might play an important role in the pathophysiology of renal adaptation to diabetes, probably as a defensive mechanism aiming to mitigate tubular suffering. Furthermore, NGAL measurement might become a useful and noninvasive tool for the evaluation of renal involvement in diabetic patients as well as for the early diagnosis of incipient nephropathy.
Bolignano
Davide
D
Department of Internal Medicine, University of Messina, Messina, Italy. buemim@unime.it
Lacquaniti
Antonio
A
Coppolino
Giuseppe
G
Donato
Valentina
V
Fazio
Maria Rosaria
MR
Nicocia
Giacomo
G
Buemi
Michele
M