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The renal tubular damage marker urinary N-acetyl-β-D-glucosaminidase may be more closely associated with early detection of atherosclerosis than the glomerular damage marker albuminuria in patients with type 2 diabetes

 So Ra Kim  ;  Yong-ho Lee  ;  Sang-Guk Lee  ;  Eun Seok Kang  ;  Bong-Soo Cha  ;  Byung-Wan Lee 
Journal Title
Issue Date
Acetylglucosaminidase/urine* ; Aged ; Albuminuria/diagnosis* ; Albuminuria/enzymology ; Biomarkers/urine ; Carotid Artery Diseases/diagnosis* ; Carotid Artery Diseases/enzymology ; Carotid Artery Diseases/urine ; Carotid Intima-Media Thickness ; Chi-Square Distribution ; Creatinine/urine ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/diagnosis* ; Diabetes Mellitus, Type 2/enzymology ; Diabetes Mellitus, Type 2/urine ; Diabetic Nephropathies/diagnosis* ; Diabetic Nephropathies/enzymology ; Diabetic Nephropathies/urine ; Early Diagnosis ; Female ; Humans ; Kidney Tubules/enzymology* ; Linear Models ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Plaque, Atherosclerotic ; Predictive Value of Tests ; Retrospective Studies ; Urinalysis
Carotid intima-media thickness ; Carotid plaque ; N-acetyl-β-D glucosaminidase ; Type 2 diabetes mellitus
BACKGROUND: To determine the association between urinary N-acetyl-β-D-glucosaminidase (NAG), a marker of renal tubulopathy, and carotid intima-media thickness (IMT) and plaques in patients with type 2 diabetes mellitus (T2D) and to compare the predictive value of NAG versus albuminuria, a marker of renal glomerulopathy. METHODS: A total of 343 participants were enrolled in this retrospective cross-sectional study. We recruited participants with T2D who were tested for blood glucose parameters, urinary NAG, and urinary albumin-to-creatinine ratio (ACR) and had been checked for carotid ultrasonography. RESULTS: We classified participants into a below-median urinary NAG group (Group I; n = 172) or an above-median group (Group II; n = 171). Mean, maximum, and mean of maximum carotid IMT and the proportion of patients with carotid plaques were significantly higher in Group II compared with Group I. In multiple linear regression analyses, high urinary NAG (Group II) was significantly associated with carotid IMT, independently of urinary ACR and other confounding factors. In terms of carotid plaques, both urinary NAG and ACR were significantly higher in participants with carotid plaques than in those without carotid plaques. After adjustment for confounding factors, both urinary NAG and ACR were significantly associated with the presence of carotid plaques. CONCLUSIONS: Elevated urinary NAG, a marker of renal tubular damage, was related to increased carotid IMT and the presence of carotid plaques in patients with T2D. Urinary NAG may be a more sensitive biomarker than urinary albumin for early detection of atherosclerosis.
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1. College of Medicine (의과대학) > Dept. of Hospital Medicine (입원의학과) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, So Ra(김소라)
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Sang-Guk(이상국) ORCID logo https://orcid.org/0000-0003-3862-3660
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
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