Changes of the tubular markers in type 2 diabetes mellitus with glomerular hyperfiltration.
OBJECTIVE
To assess whether glomerular hyperfiltration (GHF) could result in renal tubular damage in type 2 diabetes mellitus (T2DM) patients.


METHODS
Reference value of estimated glomerular filtration rate (eGFR) was determined in 248 healthy individuals based on serum CysC levels. GHF was defined as an eGFR exceeding the sex-specific 97.5th percentile in non-diabetic individuals. In the present study, 30 with GHF, 58 with norm-GFR T2DM, and 24 healthy controls were recruited. Tubular markers, such as urinary N-acetyl-β-D-glucosaminidase (NAG) and kidney injury molecule 1 (KIM-1), as well as serum and urinary neutrophil gelatinase-associated lipocalin (NGAL), were measured and compared. The correlation of these markers with eGFR was analyzed in the GHF group.


RESULTS
The GHF group had higher urinary NGAL and KIM-1 levels but lower serum NGAL level than the norm-GFR and control groups. Slightly decreased serum NGAL and increased urinary NGAL levels were also noted in the norm-GFR group compared with those of the controls. There was no statistical difference in the urinary NAG values among the three groups. Correlation analysis showed that eGFR was positively related to fasting blood glucose (FBG), HbA1c, urinary NGAL, and KIM-1, but negatively with serum NGAL in the GHF group.


CONCLUSIONS
Higher urinary tubular damage markers were found in T2DM patients with GHF than the norm-GFR and control groups, probably a direct proof that GHF is a deleterious factor for diabetic nephropathy.
Department of Laboratory, Affiliated Houjie Hospital, Guangdong Medical College, Dongguan, Guangdong 523945, China.
Wen-Jin
WJ
Fu
Bao-Liang
BL
Li
Shao-Bo
SB
Wang
Mei-Lian
ML
Chen
Ren-Tang
RT
Deng
Chang-Qin
CQ
Ye
Liang
L
Liu
Ai-Juan
AJ
Fang
Shi-Long
SL
Xiong
Shu
S
Wen
Hui-Hua
HH
Tang
Zai-Xing
ZX
Chen
Zhi-Hong
ZH
Huang
Lan-Fen
LF
Peng
Lei
L
Zheng
Qian
Q
Wang
D000118:Acetylglucosaminidase / Q000652:urine; D000209:Acute-Phase Proteins / Q000652:urine; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007684:Kidney Tubules / Q000503:physiopathology*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood / Q000652:urine; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000097:blood / Q000652:urine; D011991:Receptors, Virus
D000209:Acute-Phase Proteins; D015415:Biomarkers; D001786:Blood Glucose; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D000118:Acetylglucosaminidase