Obesity and changes in urine albumin/creatinine ratio in patients with type 2 diabetes: The DEMAND Study

2010 ◽  
Vol 20 (2) ◽  
pp. 110-116 ◽  
Author(s):  
M.C.E. Rossi ◽  
A. Nicolucci ◽  
F. Pellegrini ◽  
M. Comaschi ◽  
A. Ceriello ◽  
...  
2020 ◽  
Vol 7 (10) ◽  
pp. 1554
Author(s):  
Puneet Saxena ◽  
Deepak Chadha ◽  
Rishika Goyal ◽  
Adarsh Kenchappa Shanbogh

Background: To establish association between urine albumin creatinine ratio and ankle brachial index or peripheral arterial disease in type 2 diabetes patients.Methods: Total 74 patients of type 2 diabetes mellitus of >50 years of age subjected to calculation of urine albumin creatinine ratio and  ankle brachial index was calculated using doppler sonography and estimation of peripheral arterial diseases was done. The data obtained subjected to analysis.Results: In group with ABI <0.9 suggestive of PAD, mean age of the patient was 62.32±5.8 years, mean BMI was 26.11±2.48kg/m2, mean duration of diabetes was 11.19±41 years, 7 (18.92%) were smokers, 15 (40.54%) were insulin users, 27 (72.97%) were hypertensive, mean SBP was 142.49±13.46mmHg, mean DBP was 84±6.42mmHg, mean serum cholesterol was 221.35±17.10mg/dl, mean serum triglyceride was 242.81 ± 17.10mg/dl, mean serum HDL was 44.03±5.77mg/dl, mean serum LDL was 116.89±28.77mg/dl, mean urine ACR was 294.62±314.90mg/gm, prevalence of normoalbuminuria, microlbuminuria and macroalbuminuria was 12 (32.43%), 21 (56.76%) and 4 (10.81%)  respectively. The statistical significant difference was found in age, duration of diabetes, number of patients on insulin therapy, systolic BP, serum cholesterol, triglyceride, LDL, HDL, urine ACR and distribution of albuminuria.Conclusions: we conclude that statistical significant relationship exist between urine ACR and PAD. Hence urinary ACR can be considered as surrogate marker for early prediction of PAD in elderly patients with type 2diabetes mellitus eventually leading to aggressive intervention for prevention and management.


Author(s):  
Melly Ariyanti ◽  
Lillah Lillah ◽  
Ellyza Nasrul ◽  
Husni Husni

Urine Albumin Creatinine Ratio (UACR) merupakan metode untuk mengukur mikroalbuminuria, petanda awal dan paling banyakdigunakan untuk diagnosis nefropati diabetes. N-asetil-beta-d-glukosaminidase (NAG) air kemih adalah enzim lisosom dengan beratmolekul besar sehingga tidak difiltrasi oleh glomerulus. Ekskresi NAG di air kemih sangat mudah terganggu terutama oleh filtrasialbumin. Tujuan penelitian ini untuk mengetahui kenasaban NAG air kemih dengan UACR di pasien DM tipe 2. Penelitian ini merupakanpenelitian analitik dengan rancangan potong lintang terhadap 25 pasien DM tipe 2 yang berobat ke Poliklinik Endokrin Penyakit DalamRSUP Dr. M. Djamil Padang. Penelitian dilakukan mulai bulan Januari 2016–September 2016. Albumin air kemih diukur denganmetode imunoturbidimetri, kreatinin air kemih dengan metode Jaffe dan NAG dengan Enzyme-Linked Immune Sorbent Assay (ELISA).Kenasaban Spearman dilakukan untuk mengetahui hubungan aktivitas NAG air kemih dan UACR. Penelitian ini terdiri dari laki-laki68% dan perempuan 32%. Rerata umur 56,16±7,6 tahun dengan rentang 39–67 tahun. Kadar glukosa, ureum dan kreatinin serumberturut-turut, 148±49 mg/dL, 24±6,2 mg/dL dan 0,9±0,3 mg/dL. Normoalbuminuria sebanyak 80% dan mikroalbuminuria 20%.Median nilai UACR pasien DM tipe 2 adalah 6,02 (16,46) mg/g dengan rentang 1,53–119,41 mg/g dan rerata kadar NAG adalah51,01±31,88 ng/mL dengan rentang 9,45–144,38 ng/mL. Uji kenasaban Spearman menunjukkan kenasaban yang kuat antara aktivitasNAG air kemih dengan UACR dengan r=0,614 dan p<0,05. Terdapat kenasaban yang kuat antara aktivitas NAG air kemih denganUACR di pasien DM tipe 2.


2019 ◽  
Vol 51 (09) ◽  
pp. 595-601
Author(s):  
Yangyang Wang ◽  
Qianying Zhou ◽  
Lijun Zhang ◽  
Yali Dai ◽  
Zhijun Huang ◽  
...  

AbstractThis aim of this study was to investigate the correlation between urine haptoglobin/creatinine ratio(UHCR) and tubular injury biomarkers or severity of albuminuria in type 2 diabetes. Recruited T2DM patients (n=120) were divided into three groups based on urine albumin/creatinine ratio (UACR): normal albuminuria (Normo group, UACR<30 mg/g, n=40), microalbuminuria (Micro group, 30 mg/g ≤UACR<300 mg/g, n=38), and macroalbuminuria (Macro group, UACR ≥300 mg/g, n=42), with matched healthy individuals (NC group, n=30) as controls. ELISA assay was used to detect the levels of urine haptoglobin, NGAL and KIM-1. Automated biochemical analyzer was applied to detect the concentrations of urine creatinine and retinol binding protein (RBP). To eliminate concentration errors, urine NGAL, KIM-1, and RBP were normalized by creatinine and expressed as UHCR, UNCR, UKCR, and URCR, respectively. We found UHCR was significantly increased in T2DM patients as compared with NC group. Among the three diabetic groups, the Macro group had the highest level of UHCR, whereas the Normo group had the lowest level. T2DM patients with higher UHCR levels also had higher levels of UNCR, UKCR, and URCR. Spearman’s correlation analysis indicated that UHCR was positively correlated with UACR, UNCR, UKCR, or URCR levels, and negatively correlated with eGFR. ROC curve analysis showed that UHCR was a sensitive and specific indicator for early diagnosis of DN. Stepwise multiple regression analysis showed that UHCR and UNCR were independent variables for UACR. Our research demonstrated that UHCR correlates with tubular injury biomarkers, including UNCR, UKCR, and URCR, and is independently associated with the severity of albuminuria in T2DM.


2018 ◽  
Vol 6 (01) ◽  
pp. 50-55 ◽  
Author(s):  
Xin Zhao ◽  
Xiao-Mei Zhang ◽  
Ning Yuan ◽  
Xiao-Feng Yu ◽  
Li-Nong Ji

Abstract Objective To identify correlations of bone mineral density (BMD) and bone metabolism indices with the urine albumin to creatinine ratio (ACR) as an indicator of nephropathy in Chinese patients with type 2 diabetes (T2D). Methods In this retrospective analysis, 297 patients with T2D were divided into 3 groups according to the urine ACR. Patients’ data were analyzed to identify associations of general conditions, blood glucose level, lipid levels, and uric acid level with BMD and bone metabolism indices. Results BMD at every location tested (femoral neck, trochanter, inside hip, Ward’s triangle, total hip, and lumbar vertebrae) was negatively correlated with the urine ACR (all p<0.05). Osteocalcin, beta-C-terminal telopeptide (β-CTX), and procollagen type 1 N- peptide (P1NP) were positively correlated with urine ACR (all p<0.05). Finally, 25-hydroxyvitamin D [25(OH)D] was negatively correlated with urine ACR (p<0.05). Multiple regression analysis with adjustment for age, body mass index, disease duration, and other clinical measurements revealed no significant correlation between urine ACR and BMD measurements or β-CTX (p>0.05). However, significant correlations remained between urine ACR and osteocalcin, P1NP, and 25(OH)D (p<0.05). The same results were obtained for postmenopausal women specifically, with the exception of a significant correlation between the ACR and β-CTX (p<0.05). Conclusion In the early stage of diabetic nephropathy, BMD changes and bone transformation acceleration may occur, and the acceleration of bone transformation may occur before the change in BMD. Therefore, it is important to monitor bone metabolism indices in the early stage of diabetic nephropathy in T2D patients.


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