Urine albumin/creatinine ratio is a significant predictor for incident diabetic peripheral neuropathy in patients with Type 2 Diabetes: 3-year prospective study

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.

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Association between urine albumin creatinine ratio and high sensitivity C-reactive protein in patients with type 2 diabetes mellitus

International Journal of Clinical Biochemistry and Research ◽

10.18231/2394-6377.2018.0081 ◽

2018 ◽

Vol 5 (3) ◽

pp. 386-391

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

High Sensitivity ◽

Creatinine Ratio ◽

C Reactive Protein ◽

Albumin Creatinine Ratio ◽

Reactive Protein ◽

Urine Albumin ◽

Urine Albumin Creatinine Ratio

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CORRELATION OF URINE N-ACETYL-BETA-D-GLUCOSAMINIDASE ACTIVITY WITH URINE ALBUMIN CREATININE RATIO IN TYPE 2 DIABETES MELLITUS (Kenasaban Aktivitas N-Asetil-Beta-D-Glukosaminidase Air Kemih dengan Air Kemih Albumin Kreatinin Rasio di Diabetes Melitus Tipe 2)

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v23i3.1207 ◽

2018 ◽

Vol 23 (3) ◽

pp. 275

Author(s):

Melly Ariyanti ◽

Lillah Lillah ◽

Ellyza Nasrul ◽

Husni Husni

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Creatinine Ratio ◽

Albumin Creatinine Ratio ◽

Urine Albumin ◽

Urine Albumin Creatinine Ratio ◽

Diabetes Melitus

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.

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Albumin-Creatinine Ratio is More Diagnostic Sensitive than Cystatin-C in Assessment of Diabetic Peripheral Neuropathy

Advances in Bioengineering and Biomedical Science Research ◽

10.33140/abbsr/01/03/00002 ◽

2018 ◽

Vol 1 (3) ◽

Keyword(s):

Diabetes Mellitus ◽

Peripheral Neuropathy ◽

Cystatin C ◽

Early Treatment ◽

Diabetic Peripheral Neuropathy ◽

Diabetic Patients ◽

Creatinine Ratio ◽

Serum Cystatin C ◽

Albumin Creatinine Ratio

Background: Diabetic Peripheral neuropathy is one of the most common cardiovascular complications among diabetes mellitus patients and occurs in more than half of the population of diabetic patients world-wide. It is a common cause of foot ulcer, gangrene and amputation among diabetics. Thus, its prevention or early treatment can improve the quality of life of diabetic patients. In a bid to reduce it, various biochemical markers have been evaluated to enable early treatment and amelioration of diabetic neuropathy among diabetes mellitus patients. Aim: Evaluation of the diagnostic relevance of Cystatin-C versus Albumin-creatinine ratio in assessment of Peripheral neuropathy in diabetic type 2 subjects. Method: 102 type 2 DM subjects (66 females and 36 males) and 100 control subjects of same age range (40 – 80 years) were recruited for this study which includes 51 subjects with peripheral neuropathy and 51 subjects without peripheral neuropathy. Serum Cystatin-C, Microalbuminuria, Urine creatinine and HBA1c were analysed with standard methods. Results: Cystatin-C, Microalbuminuria, Albumin-creatinine ratio and Glycated haemoglobin were significantly elevated (P<0.05) in diabetic subjects compared to the control. Cystatin-C (ng/ml), microalbuminuria (mg/l), albumin creatinine ratio (mg/mmol) and HBA1c (%) is [105.52 ± 45.11; 90.07±20.29; 10.48 ± 4.82; 6.9±1.7] respectively. Microalbuminuria, albumin creatinine ratio showed significant increase (P<0.05) in subjects with peripheral neuropathy compared to those subjects without [92.11± 22.82; 35.70±16.35; 2.61±1.1; 6.38±1.79]. The ROC curve shows that Albumin-creatinine ratio showed significant (P<0.05) sensitivity to peripheral neuropathy [AUC=0.714] while Cystatin-C showed no significant (P<0.05) sensitivity to peripheral neuropathy complication [AUC=0.553]. Conclusion: Cystatin-C was found to be deranged in diabetics. However, Albumin-creatinine ratio showed more diagnostic sensitivity for peripheral neuropathy than Cystatin-C.

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Urine Haptoglobin/Creatinine Ratio Correlates with Tubular Injury Biomarkers and Severity of Albuminuria in Type 2 Diabetes Patients

Hormone and Metabolic Research ◽

10.1055/a-0955-6563 ◽

2019 ◽

Vol 51 (09) ◽

pp. 595-601

Author(s):

Yangyang Wang ◽

Qianying Zhou ◽

Lijun Zhang ◽

Yali Dai ◽

Zhijun Huang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Retinol Binding Protein ◽

Stepwise Multiple Regression ◽

Creatinine Ratio ◽

Tubular Injury ◽

Roc Curve Analysis ◽

Albumin Creatinine Ratio ◽

Urine Albumin ◽

Biochemical Analyzer

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.

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