PWE-104 Gamma-glutamyl transferase but not markers of hepatic fibrosis is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the edinburgh type 2 diabetes study

Introduction: Kidney damage from diabetes mellitus is called diabetic nephropathy. At the beginning it is a functional disorder, but later it results in an irreversible damage. The aim of this research was to establish damage to proximal tubular cells in patients with type 2 diabetes mellitus, and various degrees of proteinuria by determining the urinary N-acetyl-b-D-glucose-aminidase and g-glutamyl-transferase; to compare obtained results with the results in healthy examinees; to establish the correlation between these enzymes, and to investigate their sensitivity. Material and methods Patients with type 2 diabetes mellitus and creatinine clearence >80 ml/min were included in the research. Patients were divided into three groups, according to the degree of proteinuria. The first group included diabetics without microalbuminuria; the second - patients with proteinuria <300 mg/24h and microalbuminuria >20 mg/24h, and the third group included patients with proteinuria >300 mg/24h. Healthy examinees were the control group. Results: Values of the urinary N-acetyl-b-D-glucosaminidase activity were elevated before microalbuminuria was observed. The highest values were detected in the group of patients with microalbuminuria. Differences among the examined groups were statistically significant, which implies that this enzyme has a high diagnostic importance. Enzyme g-glutamyl-transferase was less sensitive in this research. The activity of this enzyme was increased only in the group of patients with proteinuria >300 mg/24h, where values increased with diabetes mellitus duration. Conclusion The increased activity of urinary N-acetyl-b-D-glucosaminidase points to early tubular damage, and can be used as a sensitive parameter in its early detection. On the other hand, gamma-glutamyl-transferase was a less sensitive damage indicator.

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Non-linear relationship between gamma-glutamyl transferase and type 2 diabetes mellitus risk: secondary analysis of a prospective cohort study

Journal of International Medical Research ◽

10.1177/0300060520937911 ◽

2020 ◽

Vol 48 (7) ◽

pp. 030006052093791

Author(s):

Hao Wang ◽

Lixia Li ◽

Shouyan Zhang

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Linear Relationship ◽

Secondary Analysis ◽

Gamma Glutamyl Transferase ◽

Non Linear ◽

Glutamyl Transferase ◽

Study Participants

Objective To investigate the association between gamma-glutamyl transferase (GGT) and type 2 diabetes mellitus (T2DM) risk. Methods This was a secondary analysis based on a publicly available DRYAD dataset that included 15 444 study participants that received medical examinations at a single centre in Japan between 2004 and 2015. Crude, minimally-adjusted and fully-adjusted regression models were used to evaluate the relationship between GGT levels and T2DM risk. Results The study participants (mean ± SD age of 43.72 ± 8.90 years; 8415 of 15 444 [54.49%] were male) were followed-up for a median of 1968 days (5.39 years). After adjusting for potential covariates, a non-linear relationship between the baseline GGT level and T2DM incidence was observed. The inflection point for T2DM risk was 10 IU/l GGT; below this point, the T2DM incidence increased by 1.18-fold per unit change in GGT. Above this point, the association between GGT and the incidence rate of T2DM became nonsignificant. Conclusion Baseline GGT exhibited a non-linear association with T2DM incidence. Elevated GGT levels should be incorporated into routine screening for individuals at high risk of T2DM, allowing for early intervention targeting GGT to potentially reduce T2DM-related morbidity.

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Urinary brush border enzymes for early diagnosis of tubular dysfunction in patients with type 2 diabetes mellitus

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192475 ◽

2019 ◽

Vol 7 (6) ◽

pp. 2015 ◽

Cited By ~ 2

Author(s):

Sasikala T. ◽

Aparna R. Bitla ◽

Alok Sachan

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Renal Dysfunction ◽

Tubular Dysfunction ◽

Gamma Glutamyl Transferase ◽

Group 3 ◽

Group 2 ◽

Glutamyl Transferase

Background: Diabetic nephropathy is a major cause of premature morbidity and mortality in type 1 and type 2 diabetes mellitus (T2DM) and hence new markers with better sensitivities are being investigated. The study was taken up to investigate whether urinary activities of N-acetyl-β-D-glycosaminidase (NAG), alkaline phosphatase (ALP), lactate dehydrogenase LDH) and Gamma glutamyl transferase (γ-GT) can be used as screening markers of renal dysfunction in patients suffering from T2DM.Methods: One hundred and four patients with T2DM along with 30 age- and gender-matched healthy individuals were included in the study. Patients were divided into three groups based on their u-MA levels i.e. normoalbuminuric (group1), micro albuminuric (group 2) and macroalbuminuric (group 3).Results: Urinary enzymes activity was significantly higher in patients with T2DM compared to controls (p<0.05). NAG, ALP, LDH, and GGT were significantly higher in group 3 compared to group1 and group 2 (p<0.0001). NAG, ALP, LDH and GGT showed significant positive correlation with MA (p=0.0001, r=0.308; p=0.0001, r=0.369; p=0.002, r=0.304, p=0.044, r=0.202 respectively). GGT and LDH showed highest sensitivity (86.21%, 84.00% respectively) and specificity (78.57%,53.49% respectively) for diagnosing renal dysfunction in patients with normoalbuminuria.Conclusions: The study suggests that u-GGT and LDH can be useful markers for assessing renal dysfunction in T2DM patients even before microalbuminuria manifests.

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