TITLE:
Urinary Neutrophil Gelatinase Associated Lipocalin as a Marker of Tubular Damage in Type 2 Diabetic Patients with and without Albuminuria
AUTHORS:
Abeer A. Al-Refai, Safaa I. Tayel, Ahmed Ragheb, Ashraf G. Dala, Ahmed Zahran
KEYWORDS:
Neutrophil Gelatinase Associated Lipocalin (NGAL); Diabetic Nephropathy; Albuminuria; Tubular Markers
JOURNAL NAME:
Open Journal of Nephrology,
Vol.4 No.1,
March
24,
2014
ABSTRACT: Background: Neuttrophil gelatinase associated lipocalin (NGAL) was shown to be a good
marker for predicting acute kidney injury (AKI). Some recent reports
demonstrated that NGAL may be an early biomarker for kidney affection in diabetic patients. The aim of this work is
to investigate urinary NGAL (UNGAL) in type 2 diabetic patients with and
without albuminuria. Methods: This study included 46 type 2 diabetic patients
and 15 healthy age and sex matched individuals as the control group. Diabetic patients were divided into three groups according
to urinary albumin excretion (UAE), normoalbuminuria, microalbuminuria and
macroalbuminuria. UNGAL was measured in all populations and corrected to urinary creatinine to account
for day to day variation in urine volume and transformed log. Comparison
between 4 groups (control, normoalbuminuria, microalbuminuria and
macroalbuminuria) was done. Results: Log UNGAL/Creatinine ratio showed significant difference when comparing control group (0.70 ± 0.58) versus normoalbuminuria (1.71 ± 1.06), microalbuminuria (1.57 ± 0.72) and macroalbuminuria (1.92 ± 0.63), however, there was no
significant difference among diabetic groups. Pearson’s correlation showed that
log UNGAL/Creatinine ratio positively correlated with glycated hemoglobin (HbA1c)
and inversely with estimated glomerular filtration rate (eGFR). Regression
analysis showed that HbA1c, urinary creatinine and eGFR were the independent
predictors of log UNGAL/Creatinine ratio. Conclusion: Tubular
markers like UNGAL may be early elevated in type 2 diabetic patients even
before the incidence of glomerular injury detected by microalbuminuria and it
can be used as an early marker for detection of kidney involvement in diabetic
patients.