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“Normoalbuminuric” diabetic nephropathy: tubular damage and NGAL

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Abstract

The aim of this study was to demonstrate that neutrophil gelatinase-associated lipocalin (NGAL) increased before the onset of microalbuminuria in patients with type 1 diabetes mellitus (T1DM), representing an important biochemical parameter with high sensitivity and specificity to make a precocious diagnosis of “normoalbuminuric” diabetic nephropathy (DN). Serum NGAL (sNGAL) and urinary NGAL (uNGAL) levels were evaluated in a cohort of fifty patients affected by T1DM. They had no signs of clinical nephropathy. Thirty-five healthy subjects (HS) were recruited. sNGAL levels were significantly higher compared with those measured in HS [193.7 (103.2–405.4) vs. 46.4 (39.8–56.2) ng/ml; p < 0.0001], as were uNGAL levels [25.5 (14.2–40.2) vs. 6.5 (2.9–8.5) ng/ml; p < 0.0001]. sNGAL was found to be directly correlated with glycated hemoglobin. uNGAL also positively correlated with albuminuria, whereas an inverse correlation was found with uric acid. After multivariate analysis, significance was maintained for the correlation between uNGAL and microalbuminuria. In ROC analysis, sNGAL showed a good diagnostic profile such as uNGAL. NGAL increases in patients with T1DM, even before diagnosis of microalbuminuria representing an early biomarker of “normoalbuminuric” DN with a good sensitivity and specificity. NGAL measurement could be useful for the evaluation of early renal involvement in the course of diabetes.

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Conflict of interest

The authors have no conflict of interest to disclose that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Messina, Messina, Italy

    Antonio Lacquaniti, Valentina Donato, Basilio Pintaudi, Giacoma Di Vieste, Antoine Buemi, Antonino Di Benedetto & Michele Buemi

  2. Department of Pediatric Sciences, University of Messina, Messina, Italy

    Valeria Chirico

  3. Unit of Clinical Microbiology, Department of Surgical Science, University of Messina, Messina, Italy

    Adriana Arena

  4. Via salita Villa Contino 30, 98100, Messina, Italy

    Michele Buemi

Authors
  1. Antonio Lacquaniti
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  2. Valentina Donato
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  3. Basilio Pintaudi
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  4. Giacoma Di Vieste
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  5. Valeria Chirico
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  6. Antoine Buemi
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  7. Antonino Di Benedetto
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  8. Adriana Arena
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  9. Michele Buemi
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Corresponding author

Correspondence to Michele Buemi.

Additional information

Communicated by Massimo Federici.

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Lacquaniti, A., Donato, V., Pintaudi, B. et al. “Normoalbuminuric” diabetic nephropathy: tubular damage and NGAL. Acta Diabetol 50, 935–942 (2013). https://doi.org/10.1007/s00592-013-0485-7

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  • DOI: https://doi.org/10.1007/s00592-013-0485-7

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