Is the urinary neutrophil gelatinase-associated lipocalin concentration in children and adolescents with type 1 diabetes mellitus different from that in healthy children?

• Published in: Biochemia Medica Vol. 34; no. 2; p. 020709
• Main Authors: Valent Morić, Bernardica, Šamija, Ivan, La Grasta Sabolić, Lavinia, Unić, Adriana, Miler, Marijana
• Format: Journal Article Paper
• Language: English
• Published: Croatia Medicinska naklada 15.06.2024; Croatian Society of Medical Biochemistry and Laboratory Medicine
• Subjects: Adolescent; albuminuria; Albuminuria - urine; Biomarkers - urine; Case-Control Studies; Child; children; Creatinine - urine; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - urine; diabetic kidney disease; Diabetic Nephropathies - diagnosis; Diabetic Nephropathies - urine; Female; Humans; Lipocalin-2 - urine; Male; Original; type 1 diabetes mellitus; urinary neutrophil gelatinase-associated lipocalin (uNGAL); diabetic kidney disease; urinary neutrophil gelatinase-associated lipocalin (uNGAL); albuminuria; type 1 diabetes mellitus; children
• ISSN: 1846-7482; 1330-0962; 1846-7482
• DOI: 10.11613/BM.2024.020709

Diabetic kidney disease (DKD) is one of the major microvascular complications of type 1 diabetes mellitus (T1DM). Some studies suggest that changes of renal tubular components emerge before the glomerular lesions thus introducing the concept of diabetic tubulopathy with urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a potential marker of DKD. This concept was not confirmed in all studies. In 198 T1DM patients with median age 15 years and diabetes duration over one year, an albumin/creatinine ratio (ACR) was determined and uNGAL measured in spot urine sample. Urine samples for ACR and uNGAL were also collected in the control group of 100 healthy children of similar age. There was no significant difference in uNGAL concentration or uNGAL/creatinine between T1DM children and healthy subjects (6.9 (2.8-20.1) ng/mL 7.9 (2.9-21.0) ng/mL, P = 0.969 and 6.8 (2.2-18.4) ng/mg 6.5 (1.9-13.4) ng/mg, P = 0.448, respectively) or between T1DM subjects with albuminuria A2 and albuminuria A1 (P = 0.573 and 0.595, respectively). Among T1DM patients 168 (85%) had normal uNGAL concentrations, while in 30 (15%) patients uNGAL was above the defined cut-off value of 30.9 ng/mL. There was no difference in BMI, HbA1c and diabetes duration between patients with elevated uNGAL compared to those with normal uNGAL. We found no significant difference in uNGAL concentration or uNGAL/creatinine between T1DM children and healthy subjects or between albuminuria A2 and albuminuria A1 T1DM subjects. Therefore, uNGAL should not be recommended as a single marker for detecting diabetic kidney disease in children and adolescents.