Kaul A, Behera M R, Rai M K, Mishra P, Bhaduaria D S, Yadav S, Agarwal V, Karoli R, Prasad N, Gupta A, Sharma R K
Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Indian J Nephrol. 2018 Jan-Feb;28(1):53-60. doi: 10.4103/ijn.IJN_96_17.
This study was carried out to look for diagnostic and prognostic role of neutrophil gelatinase-associated lipocalin (NGAL) in early diabetic nephropathy (DN) in type 2 diabetes individuals. NGAL was measured in both urinary and serum sample of 144 type 2 diabetes individuals stratified into three categories based on urinary albumin-creatinine ratio and 54 control populations with estimated glomerular filtration rate >60 mL/min/1.73 m and serum creatinine <1.2 mg/dl. The serum NGAL (sNGAL), urine NGAL (uNGAL), and uNGAL/urine creatinine were significantly higher in diabetic individuals than in the control populations with significant difference in between the groups ( < 0.05). Difference of above values between control value and normoalbuminuria was also statistically significant ( < 0.05). Again, sNGAL and uNGAL correlate positively with albuminuria ( < 0.05). Tubular injury may precede glomerular injury in diabetic individuals, and NGAL can be used as a biomarker to diagnose DN even earlier to incipient nephropathy. Both sNGAL and uNGAL can predict albuminuria and be used as a noninvasive tool for diagnosis, staging, and progression of DN.
本研究旨在探寻中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在2型糖尿病患者早期糖尿病肾病(DN)中的诊断和预后作用。对144例2型糖尿病患者的尿液和血清样本进行了NGAL检测,这些患者根据尿白蛋白肌酐比值分为三类,同时检测了54名估计肾小球滤过率>60 mL/min/1.73 m²且血清肌酐<1.2 mg/dl的对照人群。糖尿病患者的血清NGAL(sNGAL)、尿NGAL(uNGAL)和uNGAL/尿肌酐显著高于对照人群,组间差异有统计学意义(P<0.05)。对照值与正常白蛋白尿之间上述值的差异也有统计学意义(P<0.05)。此外,sNGAL和uNGAL与蛋白尿呈正相关(P<0.05)。在糖尿病患者中,肾小管损伤可能先于肾小球损伤,NGAL可作为一种生物标志物,甚至在早期肾病阶段就能更早地诊断DN。sNGAL和uNGAL均可预测蛋白尿,并可作为DN诊断、分期和病情进展的非侵入性工具。