title: Urinary Netrin-1: A New Biomarker for the Early Diagnosis of Renal Damage in Obese Children.
abstract: OBJECTIVE
  Urinary netrin-1 is a new marker to demonstrate early tubular damage. The aim of this study was to determine whether urinary netrin-1 is increased in obese children.
  
  
  METHODS
  A total of 68 normoalbuminuric and normotensive obese patients and 65 controls were included in the study. Urine samples were collected for assessment of urinary phosphorus, sodium, potassium, creatinine, albumin, and netrin-1. Blood samples were collected for measurements of fasting glucose, insulin, lipid, phosphorus, sodium, potassium, and creatinine levels. Homeostatic model assessment insulin resistance index was calculated.
  
  
  RESULTS
  Gender and age were similar between obese and control groups (12.01±3.03 vs. 11.7±3.2 years, p=0.568 and 33 vs. 35 girls, p=0.543, respectively). Obese patients had significantly higher netrin-1 excretion than the controls (841.68±673.17 vs. 228.94±137.25 pg/mg creatinine, p=0.000). Urinary netrin-1 level was significantly higher in obese subjects with insulin resistance compared to those without insulin resistance (1142±1181 vs. 604.9±589.91 pg/mg creatinine, p=0.001).
  
  
  CONCLUSIONS
  In normotensive and normoalbuminuric obese children, urinary netrin-1 level can increase before onset of albuminuria. Urinary netrin-1 excretion appears to be affected predominantly by insulin resistance and hyperinsulinemia. Urinary netrin-1 may be a new biomarker for determining early tubular injury in obese children.
authors.affiliation: Gülhane Military Medical Academy, Haydarpaşa Training and Research Hospital, Clinic of Child Health and Diseases, İstanbul, Turkey E-mail: duyguovunc@yahoo.com.tr.
authors.forename: Duygu
authors.initials: D
authors.lastname: Övünç Hacıhamdioğlu
authors.forename: Bülent
authors.initials: B
authors.lastname: Hacıhamdioğlu
authors.forename: Demet
authors.initials: D
authors.lastname: Altun
authors.forename: Tuba
authors.initials: T
authors.lastname: Müftüoğlu
authors.forename: Ferhan
authors.initials: F
authors.lastname: Karademir
authors.forename: Selami
authors.initials: S
authors.lastname: Süleymanoğlu
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood / Q000652:urine*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002648:Child; D003404:Creatinine / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000652:urine*; D008297:Male; D009414:Nerve Growth Factors / Q000652:urine*; D000075388:Netrin-1; D009765:Obesity / Q000150:complications*; D025521:Tumor Suppressor Proteins / Q000652:urine*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; C000617351:NTN1 protein, human; D009414:Nerve Growth Factors; D025521:Tumor Suppressor Proteins; D000075388:Netrin-1; D003404:Creatinine