413-P: Renal Tubular Damage Marker, Urinary N-acetyl-b-d-glucosaminidase, as a Predictive Marker of Hepatic Fibrosis in Type 2 Diabetes

• Published in: Diabetes (New York, N.Y.) Vol. 70; no. Supplement_1
• Main Authors: KIM, HAE KYUNG, KIM, YOUNG-EUN, LEE, MINYOUNG, LEE, YONG-HO, KANG, EUN SEOK, CHA, BONG-SOO, LEE, BYUNG-WAN
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01.06.2021
• Subjects: Biomarkers; Creatinine; Diabetes; Diabetes mellitus (non-insulin dependent); Fatty liver; Fibrosis; Glucosaminidase; Hyperglycemia; Kidney diseases; Steatosis
• DOI: 10.2337/db21-413-P
• ISSN: 0012-1797

Background: Nonalcoholic steatohepatitis is closely associated with the progression of diabetic kidney disease (DKD) in type 2 diabetes (T2D). We investigated whether urinary N-acetyl-β-D- glucosaminidase(u-NAG), an early renal tubular damage biomarker in DKD, could be related to the degree of hepatic fibrosis in patients with T2D. Methods: A total of 300 patients with T2D were enrolled in the study. Hepatic steatosis and fibrosis were determined using transient elastography. The levels of urinary biomarkers, including u-NAG, albumin, protein, and creatinine, and glucometabolic parameters were measured. Results: Based on the median value of u-NAG to creatinine (u-NCR), subjects were divided into normal and high u-NCR groups. The high u-NCR group showed a significantly longer duration of diabetes, worsened hyperglycemia, and a more enhanced hepatic fibrosis index. A higher u-NCR was associated with a greater odds ratio for the risk of higher hepatic fibrosis stage (F2 OR 1.99; 95% CI [1.04-3.82]; F3 and F4 OR 2.40, 95% CI [1.52-3.80]). In addition, u-NCR was an independent predictive marker for more advanced hepatic fibrosis even after adjusting for several confounding factors (β = 1.58, P <0.01). Conclusions: The elevation of u-NAG was independently associated with a higher degree of hepatic fibrosis in patients with T2D. Considering the common metabolic milieu of renal and hepatic fibrosis in T2D, the potential use of u-NAG as an effective urinary biomarker reflecting hepatic fibrosis in T2D needs to be validated in the future.