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Urinary N-acetyl-beta-D-glucosaminidase activity in type I diabetes mellitus

N Mungan1, B Yuksel, M Bakman

  • 1Division of Pediatric Endocrinology and Metabolism, Cukurova University, Faculty of Medicine, Adana, Turkey. byuksel@mail.cu.edu.tr

Indian Pediatrics
|May 28, 2003
PubMed

Insights

Urinary N-acetyl-beta-D-glucosaminidase (NAG) is elevated in children with type 1 diabetes, but doesn't reliably predict diabetic nephropathy. Elevated NAG is linked to puberty, not albuminuria markers.

Area of Science:

  • Pediatrics
  • Nephrology
  • Endocrinology

Background:

  • Type 1 diabetes mellitus (T1DM) in children and adolescents can lead to diabetic nephropathy.
  • Early detection of kidney damage is crucial for managing T1DM complications.
  • Urinary N-acetyl-beta-D-glucosaminidase (NAG) is a potential biomarker for kidney injury.

Purpose of the Study:

  • To investigate urinary albumin excretion rate (AER) and NAG activity in pediatric T1DM patients.
  • To assess the relationship between AER, NAG activity, and factors like disease duration, HbA1c, hypertension, and puberty.
  • To determine if urinary NAG activity is a useful marker for early diabetic nephropathy detection in this population.

Main Methods:

  • Measured urinary albumin excretion rate (AER) and N-acetyl-beta-D-glucosaminidase (NAG) activity in 44 children and adolescents with T1DM.
  • Compared patient values to controls.
  • Analyzed correlations between AER, NAG activity, disease duration, HbA1c, diastolic blood pressure, and pubertal status.

Main Results:

  • Both AER and urinary NAG activity were significantly higher in T1DM patients compared to controls.
  • Microalbuminuria was observed in 15.9% of patients, all of whom were pubertal.
  • AER correlated significantly with disease duration, HbA1c, diastolic blood pressure, and puberty.
  • No correlation was found between AER and urinary NAG activity.
  • Puberty was an independent factor for elevated urinary NAG activity, but NAG was not significantly correlated with other microalbuminuria-related variables.

Conclusions:

  • Urinary NAG activity is elevated in children and adolescents with T1DM.
  • Elevated urinary NAG is associated with puberty but not with AER-related factors indicative of early nephropathy.
  • Urinary NAG activity does not appear to be a reliable marker for the early detection of diabetic nephropathy in pediatric T1DM patients.

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