title: Clinical implication of urinary tubular markers in the early stage of nephropathy with type 2 diabetic patients.
abstract: OBJECTIVE
  The aim of this study was to evaluate the association of urinary tubular markers, interleukin-18 (IL-18) and angiotensinogen with albuminuria in early nephropathy of type 2 diabetics.
  
  
  METHODS
  Urine levels of tubular markers (kidney injury molecule [KIM]-1, neutrophil gelatinase-associated lipocalin [NGAL] and liver-type fatty acid-binding protein [L-FABP]), proinflammatory marker (IL-18), and a marker of intrarenal renin-angiotensin system (RAS) status (angiotensinogen) were determined in 118 patients with type 2 diabetes mellitus and 25 non-diabetic controls with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m(2).
  
  
  RESULTS
  Urinary levels of KIM-1, NGAL, IL-18 and angiotensinogen were significantly higher in macroalbuminuria group compared with control and normo- and microalbuminuria groups but not significantly different between control and normoalbuminuria group. Urinary tubular markers were positively correlated with urinary IL-18 and angiotensinogen, respectively. The urinary albuminuria was correlated with all investigated urinary markers in univariate analysis. After adjusting for several clinical parameters, urinary KIM-1, NGAL and angiotensinogen were significantly associated with albuminuria.
  
  
  CONCLUSIONS
  The results of this study suggest that urinary tubular markers may be independently associated with albuminuria in the early stage of nephropathy in type 2 diabetics (eGFR ≥ 60 mL/min/1.73 m(2)) and may reflect inflammatory processing and the activation of the intrarenal RAS.
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.forename: In Joo
authors.initials: IJ
authors.lastname: Kim
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Yang
authors.forename: Jeong Gyu
authors.initials: JG
authors.lastname: Lee
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
authors.forename: Yong Ki
authors.initials: YK
authors.lastname: Kim
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000419:Albuminuria / Q000652:urine*; D000808:Angiotensinogen / Q000652:urine; D015415:Biomarkers / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000503:physiopathology / Q000652:urine*; D050556:Fatty Acid-Binding Proteins / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D020382:Interleukin-18 / Q000652:urine*; D007684:Kidney Tubules / Q000378:metabolism*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine*; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000652:urine*; D011991:Receptors, Virus; D012307:Risk Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D000808:Angiotensinogen