Značaj koncentracija kolagena tip iv, transferina i vezujućeg proteina masnih kiselina jetre u urinu za rano otkrivanje dijabetesne nefropatije

Abstract

Diabetic nephropathy is one of the leading cause of chronic kidney disease and end-stage renal disease. It occurs in 20-40% patients with diabetes mellitus, and microalbuminuria is still considered as the first sign of diabetic nephropathy. Low sensitivity and specificity of microalbuminuria leads to more sensitive biomarkers that may be used to detect diabetic nephropathy at an earlier stage with higher accuracy. This study was carried out to determine whether urinary biomarkers such as collagen type IV, transferrin and L-FABP can serve as an indicator of diabetic nephropathy. The study included 80 diabetic adult patients who were classified into two groups: group 1 - normoalbuminuric patients (albumin excretion up to 30 mg/d), group 2 – microalbuminuric patients (albumin excretion from 30-300 mg/d) and 10 healthy controls. In our group, 44 (55%) patients were male and 36 (45%) female, mean age 59.85± 8.87 years. Prevalence of microalbuminuria was 41.25% (33 patients) and 58.75% were normoalbuminuric (47 patients). During the trial, urinary biomarker concentrations were found to be significantly higher in patients with microalbuminuria compared with patients who were normoalbuminuric. There was no statistically significant difference in the level of urinary biomarkers compared to glycoregulation, body weight index, and duration of diabetes. The results of this study have shown that collagen type IV, transferrin and L-FABP in 24 hours and the first morning urine are sensitive and specific tests for early diagnosis of diabetic nephropathy. Among them, the greatest sensitivity and specificity was shown by urinary transferrin. Although there was a correlation between urinary transferrin concentration and diabetic retinopathy.