DIABETIC NEPHROPATHY
Urinary angiotensinogen level and its risk factors in patients with " subclinical" diabetic nephropathy
Xiaoyun Yang, Baocheng Chang, Chunyan Shan, Yanguang Xu, Yi Zhang, Fei Han, Jingyu Wang, Jie Xu, Miaoyan Zheng, Huizhu Ren, Juhong Yang
Published 2015-05-25
Cite as Chin J Endocrinol Metab, 2015, 31(5): 395-399. DOI: 10.3760/cma.j.issn.1000-6699.2015.05.004
Abstract
ObjectiveTo evaluate the level and related factors of urinary angiotensinogen in patients with " subclinical" diabetic nephropathy.
Methods(1)A total of 80 type 2 diabetic patients without angiotensin-converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker(ARB) treatment and hypertension were divided into 3 groups according to 24-hour urinary albuminuria and estimated glomerular filtration rate(eGFR): normoalbuminuria with normal glomerular filtration rate group[urinary microalbuminuria(UMA) <30 mg/24 h, 90≤eGFR <120 ml·min-1·(1.73 m2)-1, NC group, n=28], normoalbuminuria with glomerular hyperfiltration group[UMA<30 mg/24 h, eGFR≥120 ml·min-1·(1.73 m2)-1, SDN group, n=36], microalbuminuria group[30 h≤UMA<300 mg/24 h, 90≤eGFR<120 ml·min-1·(1.73 m2)-1, EDN group, n=16]. The levels of urinary angiotensinogen among various groups were compared.(2)The levels of urine retinol binding protein(RBP), N-acetyl-β-D-glucosaminadase, α-galactosidase, and β2-microglobubin were used to evaluate the renal tubular function. Then all the patients were divided into 4 groups according to the degree of renal tubular injury; the urinary angiotensinogen was compared and the independent related factors were analyzed. (3)20 type 2 diabetic patients with microalbuminuria and ACEI or ARB treatment were also enrolled in this study. The level of urinary angiotensinogen was compared between patients with and without ACEI or ARB treatment.
ResultsCompared with NC group, the level of urinary angiotensinogen in the SDN group was lowered[(1.47±0.11 vs 1.59±0.11)ng/ml, P<0.05], but was raised in the EDN group[(1.62±0.15)ng/ml, P<0.05]. With the aggravation of renal tubular injury, the level of urinary angiotensinogen was increased. Multiple regression analysis showed that urinary angiotensinogen was positively correlated with RBP(P<0.05)and negatively correlated with eGFR(P<0.05). Compared with the patients without ACEI or ARB treatment, the level of urinary angiotensinogen was decreased in patients with ACEI or ARB treatment [(1.43±0.16 vs 1.62±0.15)ng/ml, P<0.05].
ConclusionThe level of urinary angiotensinogen in patients with " subclinical" diabetic nephropathy is lowered, but is then raised in patients with microalbuminuria, which may participate in the progression of renal glomerular and tubular injury in diabetic nephropathy. The renin-angiotensin system inhibitors may delay the progression of diabetic nephropathy via decreasing urinary angiotensinogen level. (Chin J Endocrinol Metab, 2015, 31: 395-399)
Key words:
Subclinical; Diabetic nephropathy; Urinary angiotensinogen; Renal tubular injury
Contributor Information
Xiaoyun Yang
Department of Diabetic Nephrology, the Metabolic Diseases Hospital, Tianjin Medical University, Key Lab of Hormones and Development, Ministry of Health, Tianjin 300070, China
Baocheng Chang
Chunyan Shan
Yanguang Xu
Yi Zhang
Fei Han
Jingyu Wang
Jie Xu
Miaoyan Zheng
Huizhu Ren
Juhong Yang