Association between nonalbumin proteinuria and renal tubular damage of N-acetyl-β-D-glucosaminidase and its clinical relevance in patients with type 2 diabetes without albuminuria

Eugene Han, Mi Kyung Kim, Yong ho Lee, Hye Soon Kim, Byung Wan Lee

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Abstract

Aim: Although albuminuria and urinary N-acetyl-β-D-glucosaminidase (uNAG) are known as progression markers of diabetic kidney disease, there is limited information regarding the association between urinary nonalbumin proteinuria (NAP) and uNAG and the clinical relevance thereof in patients without albuminuria. Methods: This cross-sectional study included samples from 244 consecutive patients with type 2 diabetes mellitus (T2D) without albuminuria. Proteinuria and albuminuria were defined according to protein-to-creatinine ratio (uPCR) and albumin-to-creatinine ratio (uACR), respectively. NAP was indirectly calculated by the difference between uPCR and uACR. Results: NAP and uNAG excretion were significantly correlated (r = 0.525, P < 0.001). Individuals whose NAP levels were in the highest tertile had a longer duration of diabetes, uncontrolled hyperglycemia, and impaired insulin stimulation (all P < 0.05), although more patients in the highest NAP tertile were prescribed insulin and sulfonylurea. Multiple linear regression analyses revealed associations among uNAG, diabetes duration, and waist circumference. Conclusions: T2D patients without albuminuria excrete proteinuria and that presence of the protein in urine is associated with uNAG. NAP was positively correlated with T2D duration and waist circumference, but negatively correlated with body mass index. Lean, but centrally obese, T2D patients in late diabetes experience more tubular damage, regardless of the presence of albuminuria.

Original languageEnglish
Pages (from-to)255-260
Number of pages6
JournalJournal of Diabetes and its Complications
Volume33
Issue number3
DOIs
Publication statusPublished - 2019 Mar

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Hexosaminidases
Albuminuria
Proteinuria
Type 2 Diabetes Mellitus
Kidney
Creatinine
Waist Circumference
Albumins
Insulin
Diabetic Nephropathies
Hyperglycemia
Linear Models
Proteins
Body Mass Index
Cross-Sectional Studies
Regression Analysis
Urine

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

@article{c0cad8e8c64b4e7bbb9bd356b8a12105,
title = "Association between nonalbumin proteinuria and renal tubular damage of N-acetyl-β-D-glucosaminidase and its clinical relevance in patients with type 2 diabetes without albuminuria",
abstract = "Aim: Although albuminuria and urinary N-acetyl-β-D-glucosaminidase (uNAG) are known as progression markers of diabetic kidney disease, there is limited information regarding the association between urinary nonalbumin proteinuria (NAP) and uNAG and the clinical relevance thereof in patients without albuminuria. Methods: This cross-sectional study included samples from 244 consecutive patients with type 2 diabetes mellitus (T2D) without albuminuria. Proteinuria and albuminuria were defined according to protein-to-creatinine ratio (uPCR) and albumin-to-creatinine ratio (uACR), respectively. NAP was indirectly calculated by the difference between uPCR and uACR. Results: NAP and uNAG excretion were significantly correlated (r = 0.525, P < 0.001). Individuals whose NAP levels were in the highest tertile had a longer duration of diabetes, uncontrolled hyperglycemia, and impaired insulin stimulation (all P < 0.05), although more patients in the highest NAP tertile were prescribed insulin and sulfonylurea. Multiple linear regression analyses revealed associations among uNAG, diabetes duration, and waist circumference. Conclusions: T2D patients without albuminuria excrete proteinuria and that presence of the protein in urine is associated with uNAG. NAP was positively correlated with T2D duration and waist circumference, but negatively correlated with body mass index. Lean, but centrally obese, T2D patients in late diabetes experience more tubular damage, regardless of the presence of albuminuria.",
author = "Eugene Han and Kim, {Mi Kyung} and Lee, {Yong ho} and Kim, {Hye Soon} and Lee, {Byung Wan}",
year = "2019",
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language = "English",
volume = "33",
pages = "255--260",
journal = "Journal of Diabetes and its Complications",
issn = "1056-8727",
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number = "3",

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TY - JOUR

T1 - Association between nonalbumin proteinuria and renal tubular damage of N-acetyl-β-D-glucosaminidase and its clinical relevance in patients with type 2 diabetes without albuminuria

AU - Han, Eugene

AU - Kim, Mi Kyung

AU - Lee, Yong ho

AU - Kim, Hye Soon

AU - Lee, Byung Wan

PY - 2019/3

Y1 - 2019/3

N2 - Aim: Although albuminuria and urinary N-acetyl-β-D-glucosaminidase (uNAG) are known as progression markers of diabetic kidney disease, there is limited information regarding the association between urinary nonalbumin proteinuria (NAP) and uNAG and the clinical relevance thereof in patients without albuminuria. Methods: This cross-sectional study included samples from 244 consecutive patients with type 2 diabetes mellitus (T2D) without albuminuria. Proteinuria and albuminuria were defined according to protein-to-creatinine ratio (uPCR) and albumin-to-creatinine ratio (uACR), respectively. NAP was indirectly calculated by the difference between uPCR and uACR. Results: NAP and uNAG excretion were significantly correlated (r = 0.525, P < 0.001). Individuals whose NAP levels were in the highest tertile had a longer duration of diabetes, uncontrolled hyperglycemia, and impaired insulin stimulation (all P < 0.05), although more patients in the highest NAP tertile were prescribed insulin and sulfonylurea. Multiple linear regression analyses revealed associations among uNAG, diabetes duration, and waist circumference. Conclusions: T2D patients without albuminuria excrete proteinuria and that presence of the protein in urine is associated with uNAG. NAP was positively correlated with T2D duration and waist circumference, but negatively correlated with body mass index. Lean, but centrally obese, T2D patients in late diabetes experience more tubular damage, regardless of the presence of albuminuria.

AB - Aim: Although albuminuria and urinary N-acetyl-β-D-glucosaminidase (uNAG) are known as progression markers of diabetic kidney disease, there is limited information regarding the association between urinary nonalbumin proteinuria (NAP) and uNAG and the clinical relevance thereof in patients without albuminuria. Methods: This cross-sectional study included samples from 244 consecutive patients with type 2 diabetes mellitus (T2D) without albuminuria. Proteinuria and albuminuria were defined according to protein-to-creatinine ratio (uPCR) and albumin-to-creatinine ratio (uACR), respectively. NAP was indirectly calculated by the difference between uPCR and uACR. Results: NAP and uNAG excretion were significantly correlated (r = 0.525, P < 0.001). Individuals whose NAP levels were in the highest tertile had a longer duration of diabetes, uncontrolled hyperglycemia, and impaired insulin stimulation (all P < 0.05), although more patients in the highest NAP tertile were prescribed insulin and sulfonylurea. Multiple linear regression analyses revealed associations among uNAG, diabetes duration, and waist circumference. Conclusions: T2D patients without albuminuria excrete proteinuria and that presence of the protein in urine is associated with uNAG. NAP was positively correlated with T2D duration and waist circumference, but negatively correlated with body mass index. Lean, but centrally obese, T2D patients in late diabetes experience more tubular damage, regardless of the presence of albuminuria.

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