Association between Urinary N-Acetyl-Beta-D-Glucosaminidase and Microalbuminuria in Diabetic Black Africans

Udomah, F; Ekrikpo, Udeme; Effa, Emmanuel; Bl, Salako; Arije, A; Kadiri, S

doi:10.1155/2012/235234

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…We found that urinary NAG levels were significantly increased in patients with microalbuminuria compared to those with normoalbuminuria, thus corroborating previous studies performed in type 2 diabetic patients (8)(9)(10). We also observed a significant positive correlation between urinary NAG excretion and ACR which is consis- tent with the data reported by other studies in patients with T2DM (14) as well as in type 1 diabetic patients (15). These findings suggest that tubular dysfunction, evidenced by an increase in urinary NAG excretion, is already present in the microalbuminuria stage of DN in T2DM and that it becomes exacerbated with the degree of albuminuria.…”

Section: Discussionsupporting

confidence: 92%

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Evaluation of urinary N-acetyl-beta-D-glucosaminidase as a marker of early renal damage in patients with type 2 diabetes mellitus

Bouvet

Paparella

Arriaga

et al. 2014

Arq Bras Endocrinol Metab

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Objective: To evaluate the clinical usefulness of urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion for the detection of early tubular damage in type 2 diabetes mellitus (T2DM). Subjects and methods: Thirty six patients with T2DM were divided into two groups based on urinary albumin to creatinine ratio (ACR): normoalbuminuria (ACR < 30 mg/g; n = 19) and microalbuminuria (ACR = 30-300 mg/g; n = 17). The following parameters were determined in both groups: urinary NAG and albumin, serum and urine creatinine, fasting plasma glucose and glycated hemoglobin (HbA 1c ). Results: Urinary NAG levels [Units/g creatinine; median (range)] were significantly increased in microalbuminuria group [17.0 (5.9 -23.3)] compared to normoalbuminuria group [4.4 (1.5 -9.2)] (P < 0.001). No differences between groups were observed in fasting glucose, HbA 1c , serum creatinine levels and estimated glomerular filtration rates (eGFR). Urinary NAG positively correlated with ACR (r = 0.628; p < 0.0001), while no significant association was observed between NAG and glycemia, HbA 1c , serum creatinine and eGFR. RESUMOObjetivo: Avaliar a utilidade clínica da excreção urinária da N-acetil-beta-D-glucosaminidase (NAG) para a detecção de dano tubular precoce no diabetes melito tipo 2 (DM2). Sujeitos e méto-dos: Foram estudados trinta e seis pacientes com DM2 que se dividiram em dois grupos com base na excreção urinária de albumina (EUA): normoalbuminúrico (EUA < 30 mg/g de creatinina; n = 19) e microalbuminúrico (EUA = 30-300 mg/g de creatinina; n = 17). Em ambos os grupos foram determinados os seguintes parâmetros: NAG e albumina urinária, creatinina sérica e urinária, glicemia de jejum e hemoglobina glicada (HbA 1c ). Resultados: Os níveis de NAG urinária [unidades/g de creatinina; mediana (intervalo interquartílico)] foram significativamente maiores no grupo microalbuminúrico [17,0 (5,9 -23,3)] em comparação com o grupo normoalbuminúrico [4,4 (1,5 -9,2)] (p < 0,001). Não se observaram diferenças significativas entre os dois grupos nos níveis de glicemia de jejum, HbA 1c , creatinina sérica e taxa de filtração glomerular estimada (TFGe). A NAG urinária se correlacionou positivamente com o EUA (r = 0,628, p < 0,0001), não sendo observada associação significativa da NAG com glicemia, HbA 1c , creatinina sérica e TFGe. Conclusões: O aumento da NAG urinária na fase de microalbuminúria da nefropatia diabética (ND) sugere que a disfunção tubular já está presente nesse período. A associação positiva significativa entre a excreção urinária da NAG e EUA indica a possível aplicação clínica da NAG urinária como marcador complementar para a detecção precoce da ND no DM2. Arq Bras Endocrinol Metab. 2014;58(8):798-801 Descritores Nefropatia diabética; diabetes melito tipo

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Section: Discussionsupporting

confidence: 92%

“…The lack of correlation between urinary NAG excretion and glycemic state are consistent with those results reported by other authors in type 2 diabetic patients (9,14). However, data from the literature referred to T2DM are controversial (10,17), while in type 1 diabetic patients such a relation is more clearly evidenced (15).…”

Section: Discussionsupporting

confidence: 90%

Evaluation of urinary N-acetyl-beta-D-glucosaminidase as a marker of early renal damage in patients with type 2 diabetes mellitus

Bouvet

Paparella

Arriaga

et al. 2014

Arq Bras Endocrinol Metab

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“…Results from this study showed a significant increase in both urinary NAG activity and NAG/Cr in diabetics compared with controls. These corroborate work done elsewhere [13, 22, 23]. This study also found significant elevations in both urinary AAP activity and AAP/Cr in the diabetics compared with controls.…”

Section: Discussionsupporting

confidence: 93%

Urinary Lysosomal Enzyme Activities and Albuminuria in Ghanaian Patients with Type 2 Diabetes Mellitus

et al. 2016

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Renal tubular lysosomal enzyme activities like alanine aminopeptidase (AAP) and N-acetyl-β-D-glucosaminidase (NAG) have been shown to increase in patients developing diabetic nephropathy and nephrosclerosis. This study aimed to determine the activities of N-acetyl-β-D-glucosaminidase and alanine aminopeptidase and albumin concentration in urine samples of patients with type 2 diabetes. One hundred and thirty (65 type 2 diabetic and 65 nondiabetic) subjects participated in this study. Blood samples were drawn for measurements of fasting blood glucose, albumin (Alb), lipids, and creatinine (Cr). Early morning spot urine samples were also collected for activities of alanine aminopeptidase (AAP), N-acetyl-β-D-glucosaminidase (NAG), and concentration of albumin (U-Alb) and creatinine (U-Cr). Both NAG/Cr and AAP/Cr were significantly increased in diabetic subjects compared to controls (p < 0.001). There was positive correlation between NAG/Cr and Alb/Cr (r = 0.49, p < 0.001) and between NAG/Cr and serum creatinine (r = 0.441, p < 0.001). A negative correlation was found between NAG/Cr and eGFR (r = −0.432, p < 0.05). 9.3% and 12% of diabetics with normoalbuminuria had elevated levels of AAP/Cr and NAG/Cr, respectively. We conclude that measuring the urinary enzymes activities (NAG/Cr and AAP/Cr) could be useful as a biomarker of early renal involvement in diabetic complications.

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“…One study suggests that the initial renal damage resulting in microalbuminuria is the loss of charge-dependent tubular protein reabsorption occurring prior to the damage of the glomerular charge barrier in diabetics [ 22 ] while another has shown in diabetic children that tubular proteinuria actually predates microalbuminuria [ 23 ]. We have previously demonstrated early tubular dysfunction in African diabetics using urinary NAG suggesting that tubular dysfunction may precede glomerular damage [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Utility of Urinaryβ2-Microglobulin in Detection of Early Nephropathy in African Diabetes Mellitus Patients

Ekrikpo

Effa

Akpan

et al. 2017

International Journal of Nephrology

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Background. Studies have indicated that diabetic tubulopathy may occur earlier than glomerulopathy, therefore providing a potential avenue for earlier diagnosis of diabetic nephropathy. Urinary beta-2-microglobulin (β2m) was investigated in this study as a potential biomarker in the detection of early nephropathy in type 2 diabetics. Methods. One hundred and two diabetic subjects and 103 controls that met the inclusion criteria had data (sociodemographic, medical history, physical examination, and laboratory) collected. Urinary β2m levels and urinary albumin concentration (UAC) were determined. Results. Elevated urinary β2m was more frequent among the diabetics (52%, 95% CI: 42.1–61.8%) than among the controls (32%, 95% CI: 22.9–41.2%). The frequency of microalbuminuria was higher in the diabetics (35.3%, 95% CI: 25.9–44.7%) than in the controls (15.5%, 95% CI: 8.4–22.6%). There was a positive correlation between urinary β2m and UAC (rho = 0.38, p < 0.001). Multivariate analysis showed BMI (OR: 1.23, 95% CI: 1.05–1.45), eGFR (OR: 0.97, 95% CI: 0.94–0.99), and presence of microalbuminuria (OR: 3.94, 95% CI: 1.32–11.77) as independent predictors of elevated urinary beta-2-microglobulin among the diabetics. Conclusion. Urinary β2m may be useful, either as a single test or as a component of a panel of tests, in the early detection of diabetic nephropathy.

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Association between Urinary N-Acetyl-Beta-D-Glucosaminidase and Microalbuminuria in Diabetic Black Africans

Cited by 10 publications

References 24 publications

Evaluation of urinary N-acetyl-beta-D-glucosaminidase as a marker of early renal damage in patients with type 2 diabetes mellitus

Evaluation of urinary N-acetyl-beta-D-glucosaminidase as a marker of early renal damage in patients with type 2 diabetes mellitus

Urinary Lysosomal Enzyme Activities and Albuminuria in Ghanaian Patients with Type 2 Diabetes Mellitus

Clinical Utility of Urinaryβ2-Microglobulin in Detection of Early Nephropathy in African Diabetes Mellitus Patients

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