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Urinary N-acetyl-beta-D-glucosaminidase activity in type I diabetes mellitus
1Division of Pediatric Endocrinology and Metabolism, Cukurova University, Faculty of Medicine, Adana, Turkey. byuksel@mail.cu.edu.tr
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.
Abstract:
We measured urinary albumin excretion rate (AER) and N-acetyl-beta-D-glucosaminidase (NAG) activity in relation to disease duration, acetylated hemoglobin (HbA1c), hypertension and puberty in 44 children and adolescents with type 1 diabetes mellitus. AER and Urinary NAG activity were significantly higher in the patients compared to controls (AER 19.4 +/-; 35.8 vs 4.7 +/- 4.4, NAG activity 5.6 +/- 0.6U vs. 1.6 +/- 0.2U). Microalbuminuria was present in seven patients (15.9%), all of whom were pubertal. There was no correlation between AER and urinary NAG activity. There was a significant direct correlation between AER and disease duration (P <0.05), HbA1c (P < 0.05), diastolic blood pressure (P <0.05) and puberty (P <0.05). None of the microalbuminuria related variables was significantly correlated with urinary NAG activity. Puberty was an independent factor for elevated urinary NAG activity. This study shows that urinary NAG is elevated in children and adolescents with type 1 diabetes mellitus, but is not associated with AER related factors except for puberty. Urinary NAG activity does not appear to be a useful marker for early detection of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus.