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Abstract: FR-PO458

Associations of Urinary NGAL and RBP with Nephropathy and Their Roles in Normoalbuminuric Renal Insufficiency in T2DM

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Zhang, Hao, The Third Xiangya Hospital of Central South University, Changsha, HUNAN, China
  • Li, Aimei, the Third Xiangya Hospital, Central South University, Changsha, China
  • Yi, Bin, The Third Xiangya Hospital of Central South University, Changsha, HUNAN, China
  • Zhang, Wei, the Third Xiangya Hospital, Central South University, Changsha, China
Background

Diabetic nephropathy(DN)is an important complication of diabetes mellitus and has become the leading cause of end-stage renal disease (ESRD) worldwide. At present, the diagnosis of DN mainly depends on glomerular filtration rate (GFR) and albuminuria, but both of them have limitations. In addition, some patients follow a non-albuminuric pathway to renal impairment. The aim of this study was to investigate novel biomarkers in urine to reflect renal damage in T2DM.

Methods

This is a cross-sectional study recruiting 269 type 2 diabetic patients and 30 control subjects. Urinary neutrophil gelatinase-associated lipocalin (NGAL), retinol binding protein (RBP), plasminogen activator inhibitor-1(PAI-1), vascular cell adhesion molecule-1 (VCAM-1), E-cadherin, as well as urinary albumin excretion were measured in urine. Glomerular filtration rate (GFR) was estimated via CKD-EPI combined creatinine–cystatin C equation. The patients were further categorized based on urine albumin/creatinine ratio (UACR) or eGFR. Their correlations with UACR and eGFR were analyzed. Plasma TNF-α, IL-6, ET-1 and 8-OHdG was tested in patients with normoalbuminuria. The associations of TNF-α, IL-6, ET-1 and 8-OHdG with eGFR and urinary biomarker were analyzed. Sensitivity, specificity, and area under the curve (AUC) were calculated as measures of diagnostic accuracy.

Results

It was observed that the levels of urinary NGAL, RBP and PAI-1 were significantly elevated and correlated with UACR and eGFR in T2DM. In T2DM patients with UACR<30mg/g, plasma TNF-α, IL-6 and 8-OHdG were increased in patients with renal insufficiency, and plasma TNF-α and 8-OHdG were negatively correlated with eGFR. Urinary NGAL and RBP were statistically elevated in patients with renal insufficiency and inversely correlated with eGFR. In addition, urinary NGAL showed a positive correlation with plasma TNF-α and 8-OHdG, and urinary RBP showed a positive correlation with plasma 8-OHdG.

Conclusion

In conclusion, the results indicate that urinary NGAL, RBP and PAI-1 may serve as novel biomarkers for the diagnosis of nephropathy in T2DM and urinary NGAL and RBP may be promising biomarkers for diagnosing renal impairment in T2DM patients with normoalbuminuric.

Funding

  • Government Support - Non-U.S.