Increased Urinary Transferrin Excretion in Exercising Normoalbuminuric Insulin-Dependent Diabetic Patients

Abstract

SUMMARY.The median rate of urinary transferrin excretion is greatly increased by exercise in subjects with uncomplicated type 1 (insulin-dependent) diabetes. This increase is proportionally far greater than that seen in urinary albumin excretion rate after the same exercise. Non-diabetic control subjects showed no rise in urinary transferrin excretion rate following exercise. N-acetyl-fl-D-glucosaminidase excretion rate was higher in diabetic than control groups but did not rise with exercise.Our results suggest that patients with apparently uncomplicated diabetes have abnormal renal function. In this group an elevated urinary transferrin excretion rate appears to be a more sensitive indicator of altered renal function than is elevated albumin excretion rate. The mechanism underlying exercise-induced urinary loss of transferrin remains to be elucidated.

Beneficial Effects of Physical Activity in Diabetic Patients

“…This physiological response is to be considered as an indicator of early diabetic nephropathy. An important role is played by the workload, which during PA could modify the albumin values [43]. Individuals with and without diabetes were compared to those who had urinary albumin excretion after physical stress, and then, the differences between these two groups of individuals were identified [44].…”

The role of novel biomarkers in predicting diabetic nephropathy: a review

“…[60][61][62] In fact, urinary transferrin has been considered as a more sensitive biomarker of glomerular injury in diabetes mellitus. [63][64][65] This is because patients with diabetes mellitus have increased likelihood of presenting with urinary transferrinuria than with albuminuria, while albumin/transferrin ratio is significantly lower in diabetic patients with normoalbuminuria and microalbuminuria than in those with macroalbuminuria. 66 In addition, transferrinuria predicts the development of microalbuminuria in patients with T2DM who have normoalbuminuria.…”

Urinary Markers of Glomerular Injury in Diabetic Nephropathy

“…Because diabetic patients are more likely to have transferrinuria than albuminuria [44, 49–54], and because the albumin/transferrin ratio was significantly smaller in normoalbuminuric and microalbuminuric compared to macroalbuminuric patients, urinary transferrin is considered to be a more sensitive marker of glomerular damage in diabetic patients [44, 50–54]. Furthermore, increased urinary transferrin excretion predicts the development of microalbuminuria in type 2 diabetic patients with normoalbuminuria [55, 56]; in patients that already developed albuminuria, the urinary transferrin excretion has a linear relationship with UAE [39, 40, 42–44, 47, 50, 53, 57–60].…”