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Transferrinuria And Urine N-acetyl-beta-d-glucosaminidase As Adegenerative Complication Determinant In Diabetes Mellitus
İlhan YETKİN*, Şebnem KÖSEBALABAN**, Nazan ARPACIOĞLU**, Göksun AYVAZ*
* Dr.,Gazi Üniversitesi Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları AD,** Dr.,SSK Ankara Eğitim Hastanesi Biokimya Kliniği, ANKARA
Glomerular hyperfiltration and nephromegaly have been detected and microalbuminuria has been seen before the diabetic nephropathy becomes cliniclly obvious. The aim of this study is to appreciate the value of transferrinuria as an alternative to microalbuminuria in early diagnosis of diabetic nephropathy. In this study, we detected the levels of microalbuminuria, and transferrinuria, the levels of N Acetyl beta-D-Glycosaminidase(NAG) and creatinin in urine in 56 diabetic patients (28 male, 28 female). We also detected the levels of microalbuminuria and transferrinuria and the levels of NAG and creatinin in urine in 30 healthy subjects same as the patients compared in age, sex, and body mass index(BMI). We calculated the albumin/creatinin(A/C) ratio and the transferrine/creatinine(T/C) ratio of urine samples. According to the A/C ratio we classified the patients in three groups: as the group A(A/C: 2.5 mg/mmol), the group B(A/C:2.5-26.8 mg/mmol), the group C(A/C:greater than 26.8 mg/mmol). When A/C ratio and T/C ratio of group B and the group C were compared with the group A, there was a significant difference (p<0.001). There were positive correlations between the levels of NAG in urine and the levels of albumine in urine(r=0.46, p<0.01) between the levels of NAG in urine and the levels of transferrine in urine, (r=0.46, p<0.0001) and between the levels of tranferrine in urine and the levels of albumine in urine(r=0.86, p<0.0001). Where as the T/C ratio of the group B was 8.4 times higher than that of the healthy subjects, the A/C ratio of the group B was 4.8 times higher than that of the healthy subjects.
As a result, it is suggested that transferrinuria may be more sensitive as an indicator for diabetic nephropathy compared with microalbuminuria.
Keywords: Diabetic nepropathy, Microalbuminuria,
Transferrinuria,
N Acetyl-beta-D-Glycosaminidase
Turkiye Klinikleri J Med Sci 1998, 18:255-259
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