Urine biomarkers in type 2 diabetes mellitus with or without microvascular complications

• Published in: Nutrition & diabetes Vol. 14; no. 1; pp. 51 - 6
• Main Authors: Zhang, Chanyuan, Liu, Tiebing, Wang, Xiaoqian, Yang, Jing, Qin, Dongfang, Liang, Yin, Wang, Xuejing
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 10.07.2024; Nature Publishing Group
• Subjects: 631/45/612; 692/699/2743/137; Adult; Aged; Albuminuria - urine; Alpha-Globulins - urine; beta 2-Microglobulin - urine; Biomarkers; Biomarkers - urine; Clinical Nutrition; Creatinine - urine; Cystatin C - blood; Cystatin C - urine; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - urine; Diabetic Angiopathies - urine; Diabetic Nephropathies - urine; Diabetic Retinopathy - urine; Epidemiology; Female; Humans; Internal Medicine; Lipocalin-2 - urine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Retinol-Binding Proteins - urine; Urine
• ISSN: 2044-4052; 2044-4052
• DOI: 10.1038/s41387-024-00310-5

Objective To investigate the distribution of nine (9) urine biomarkers in people living with type 2 diabetes mellitus (T2DM), with or without microvascular complications. Methods In total, 407 people with T2DM were enrolled from 2021 to 2022. According to diabetic retinopathy (DR) and urinary albumin-creatinine ratio (UACR), the 407 people were divided into four (4) groups, DR(–)UACR(–), DR(+)UACR(–), DR(–)UACR(+), and DR( + )UACR(+). In addition, 112 healthy volunteers were enrolled during the same period. The nine (9) urine markers included α1-microglobulin (u-α1MG), immunoglobulin G (u-IgG), neutrophil gelatinase-associated lipid carrier protein (u-NGAL), cystatin C (u-CysC), retinol-binding protein (u-RBP), β2-microglobulin (u-β2MG), N-acetyl-β-D-glucosaminidase (u-NAG), transferrin (u-Trf), and collagen type IV (u-Col). For each marker, the respective level of 97.5 percentile in healthy volunteers was taken as an upper reference limit. Results Among the 407 people, 248 individuals (61%) were DR(–)UACR(–), 100 (25%) were DR(-)UACR(+), 37 (9%) were DR(+)UACR(–), and 22 (5%) were DR(+)UACR(+). The u-NAG/Cr biomarker level showed a significant difference between healthy participants and people with T2DM. In the DR(–)UACR(–)group, u-Trf/Cr showed the highest positive rate (21.37%), followed by u-IgG/Cr (14.52%); u-NAG/Cr (10.48%); u-β2MG/Cr (4.44%); u-CysC/Cr (4.03%); u-NGAL/Cr (4.03%); u-RBP/Cr (2.82%); u-α1MG/Cr (2.42%); 17.34% of people with T2DM showed multiple biomarkers positive (≥2 biomarkers). The positive rates of one biomarker (21.33%) and two biomarkers (18.67%) in people who have less than five (5) years of T2DM were almost close to those of the DR(–)UACR(–) group (21.37%, and 12.10%, respectively). Conclusion Renal tubule biomarkers may be used as an indicator in the early detection and monitoring of renal injury in diabetes mellitus. The u-NAG biomarker should be measured for the people with T2DM of the first-time diagnosis.