Urinary brush border enzymes for early diagnosis of tubular dysfunction in patients with type 2 diabetes mellitus

Abstract

Background: Diabetic nephropathy is a major cause of premature morbidity and mortality in type 1 and type 2 diabetes mellitus (T2DM) and hence new markers with better sensitivities are being investigated. The study was taken up to investigate whether urinary activities of N-acetyl-β-D-glycosaminidase (NAG), alkaline phosphatase (ALP), lactate dehydrogenase LDH) and Gamma glutamyl transferase (γ-GT) can be used as screening markers of renal dysfunction in patients suffering from T2DM.Methods: One hundred and four patients with T2DM along with 30 age- and gender-matched healthy individuals were included in the study. Patients were divided into three groups based on their u-MA levels i.e. normoalbuminuric (group1), micro albuminuric (group 2) and macroalbuminuric (group 3).Results: Urinary enzymes activity was significantly higher in patients with T2DM compared to controls (p<0.05). NAG, ALP, LDH, and GGT were significantly higher in group 3 compared to group1 and group 2 (p<0.0001). NAG, ALP, LDH and GGT showed significant positive correlation with MA (p=0.0001, r=0.308; p=0.0001, r=0.369; p=0.002, r=0.304, p=0.044, r=0.202 respectively). GGT and LDH showed highest sensitivity (86.21%, 84.00% respectively) and specificity (78.57%,53.49% respectively) for diagnosing renal dysfunction in patients with normoalbuminuria.Conclusions: The study suggests that u-GGT and LDH can be useful markers for assessing renal dysfunction in T2DM patients even before microalbuminuria manifests.

The in-Vivo Effect of Sodium Fluoride on the Activities of Renal Enzymes in the Brush Border Membrane of Rat Kidney Is Mitigated by Supplementing With Leaf Extract of Boerhaavia Diffusa L.

“…Alkaline phosphatase is a family of cell surface glycoprotein that catalyzes the hydrolysis of phosphomonoesters with release of inorganic phosphate. Four major alkaline phosphatase isoenzymes have been characterized from human, each encoded by a separate gene, three of them are expressed in intestine, placenta and germ cells whereas the fourth isoenzyme is highly expressed in liver, bone and kidney and low in other tissues (Sasikala et al, 2019).…”