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Indian Journal of Clinical Biochemistry logoLink to Indian Journal of Clinical Biochemistry
. 2006 Sep;21(2):142–148. doi: 10.1007/BF02912930

Urinary N-acetyl beta glucosaminidase and gamma glutamyl transferase as early markers of diabetic nephropathy.

Vivek Ambade 1,, Parduman Sing 1, B L Somani 1, Dashrath Basanna 2
PMCID: PMC3454003  PMID: 23105632

Abstract

Albumin and enzymes-N-acetyl-beta-glucosaminidase (NAG) and gamma glutamyl transferase (GGT) were estimated in the morning random urine samples of 196 albustix negative diabetic patients to evaluate the clinical utility of these urinary enzymes as early markers of diabetic nephropathy. Albumin was estimated by immunoturbidimetric method and enzymes by linetic essay within six hours of voiding of urine. The urinary albumin and urinary enzyme concentration was calculated in terms of ratio with respect to urinary creatinine. Correlation coefficient (r) bewween urinary albumin and urinary enzymes in normoalbuminuric, microalbuminuric and overall diabetic cases was 0.23, 0.32 and 0.40 respectively for NAG, and 0.08, 0.06 and 0.18 respectively for GGT. NAG excretion was found increased in 34%, 63.7% and 49.5% of normoalbuminuric, microalbuminuric and overall diabetic cases respectively while GGT in 6.4%, 24.5% and 15.8%. The correlation coefficient between urinary albumin and NAG in normoalbuminuric, microalbuminuric, and overall diabetic patients with increased NAG excretion was found only 0.31, 0.27 and 0.35 respectively. No correlation was found between duration of diabetes and enzyme excretion. The study suggests that urinary NAG or GGT or both together do not have any clinical significance as an early marker of diabetic nephropathy.

Key words: Microalbuminuria, Diabetic nephropathy, N-acetyl-beta-glucosaminidase, Gamma glutamyl transferase

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References

  • 1.Hess B. Antihypertensive therapy in diabetes mellitus. Ther. Umsch. 1999;56(1):25–32. doi: 10.1024/0040-5930.56.1.25. [DOI] [PubMed] [Google Scholar]
  • 2.Sheth J.J. Diabetes, microalbuminuria and hypertension. Clin. Exp. Hypertens. 1999;21(1-2):61–8. doi: 10.3109/10641969909068649. [DOI] [PubMed] [Google Scholar]
  • 3.Lehmann R., Spinas G.A., Schweiz R. Diabetic nephropathy: significance of microalbuminuria and proteinuria in Type I and Type II diabetes mellitus. Med. Prax. 1995;84(44):1265–71. [PubMed] [Google Scholar]
  • 4.Parving H.H. Microalbuminuria in essential hypertension and diabetes mellitus. J. Hypertens. Suppl. 1996;14(2):89–94. doi: 10.1097/00004872-199609002-00017. [DOI] [PubMed] [Google Scholar]
  • 5.Manadevan S., Dillard C. J., Tappell A. L. Degradation of polysaccharides, mucopolysaccharides and glycoprotein by lysosomal glycosidases. Archeives Biochem. Biophys. 1969;129:525–33. doi: 10.1016/0003-9861(69)90210-0. [DOI] [PubMed] [Google Scholar]
  • 6.Albert Z., Orlowski M., Szewczuk A. Histochemical demonstration of—glutamyl transpeptidase. Nature (London) 1961;191:767–8. doi: 10.1038/191767a0. [DOI] [PubMed] [Google Scholar]
  • 7.Miller S. P., Awasti Y. C., Srivastawa S. K. Studies of human kidney-glutamyl transpeptidase. Journal of Biological Chem. 1976;251:2271–8. [PubMed] [Google Scholar]
  • 8.Ambade V. Urinary enzymes as markers for early diagnosis of diabetic nephropathy. New Delhi.: Director General Armed Forces Medical Services, Ministry of Defence, Govt. of India; 2002. [Google Scholar]
  • 9.Jung K., Schulze G., Reinholdt C. Different diuresis-dependent excretions of urinary enzymes: N-acetyl-beta-D-glucosaminidase, alanine aminopeptidase, alkaline phosphatase, and gamma-glutamyltransferase. Clin. Chem. 1986;32(3):529–32. [PubMed] [Google Scholar]
  • 10.Hsu W.S., Kao J.T., Chen J.S. Clinical significance of urinary N-acetyl-beta-D-glucosaminidase and alanine aminopeptidase. Taiwan I Hsueh. Hui. Tsa. Chih. 1989;88(4):407–9. [PubMed] [Google Scholar]
  • 11.Nakamura S. Clinical evaluation of urinary alanine aminopeptidase in the patients with diabetes mellitus-comparison among AAP, microalbumin and N-acetyl-beta-D-glucosaminidase. Hokkaido. Igaku. Zasshi. 1991;66(4):522–33. [PubMed] [Google Scholar]
  • 12.Morita E., Kaizu K., Uriu K., Eto S. Clinical significance of urinary enzymes in diabetes mellitus. Sangyo Ika. 1990;12(2):197–205. doi: 10.7888/juoeh.12.197. [DOI] [PubMed] [Google Scholar]
  • 13.Junko M., Miyako O., Masaaki K., Kazuo I., Kiyomi H., Kenji Y. Kinetic rate assay of N-acetyl-β-D-glucosaminidase with 2-chloro-4-nitrophenyl-N-acetyl-β-D-glucosaminide as substrate. Clin. Chem. 1988;34/10:2140–43. [PubMed] [Google Scholar]
  • 14.Junko M., Emiko S., Miyako O., Masaaki K., Kiyomi H., Kenji Y. Improved kinetic rate assay of N-acetyl-β-D-glucosaminidase with 2-chloro-4-nitrophenyl-N-acetyl-β-D-glucosaminide as substrate. Clin. Chem. 1990;36/2:319–22. [PubMed] [Google Scholar]
  • 15.Amodio P., Bazzerla G., Malatesta R., Gatta A. Reference ranges and methodological aspects in the urinary measuring of lysozyme, malate dehydrogenase, gamma-glutamyltransferase and alpha-glucosidase. Enzyme. 1985;33(4):216–25. doi: 10.1159/000469436. [DOI] [PubMed] [Google Scholar]
  • 16.Ellis E.N., Brouhard B.H., Lagrone L., Travis L.B. Urinary excretion of N-acetyl-beta-D-glucosaminidase in children with type I diabetes mellitus. Diabetes Care. 1983;6(3):251–55. doi: 10.2337/diacare.6.3.251. [DOI] [PubMed] [Google Scholar]
  • 17.Minakami H. Clinical evaluation of N-acetyl-beta-D-glucosaminidase on prediction of diabetic nephropathy. Hokkaido Igaku Zasshi. 1992;67(2):234–46. [PubMed] [Google Scholar]
  • 18.Cohen N., Gertler A., Atar H., Bar-Khayim Y. Urine and serum leucine aminopeptidase, N-acetyl-beta-glucosaminidase and gamma-glutamyl transpeptidase activities in diabetics with and without nephropathy. Israel J. Med. Sci. 1981;17(6):422–5. [PubMed] [Google Scholar]
  • 19.Morita E., Kaizu K., Uriu K., Hashimoto O., Komine N., Eto S. Clinical significance of urinary enzymes in diabetic nephropathy [Article in Japanese] HNO. 1991;5(2-3):158–9. doi: 10.1016/0891-6632(91)90056-u. [DOI] [PubMed] [Google Scholar]
  • 20.Ikenaga H., Suzuki H., Ishii N., Itoh H., Saruta T. Enzymuria in non-insulin-dependent diabetic patients: signs of tubular cell dysfunction. Clin. Sci. (Colch) 1993;84(4):469–75. doi: 10.1042/cs0840469. [DOI] [PubMed] [Google Scholar]
  • 21.Cheung C.K., Yeung V.T., Cockram C.S., Swaminathan R. Urinary excretion of albumin and enzymes in non-insulin-dependent Chinese diabetics. Clin. Nephrol. 1990;34(3):125–30. [PubMed] [Google Scholar]
  • 22.Gibb D.M., Tomlison P.A., Dalton N.R., Turner C., Shah N., Barratt T.M. Renal tubular proteinuria and microalbuminuria in diabetic patients. Arch. Dis. Child. 1989;64:129–34. doi: 10.1136/adc.64.1.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Jones A.P., Lock S., Griffiths K.D. Urinary N-acetyl-beta-glucosaminidase activity in type I diabetes mellitus. Ann. Clin. Biochem. 1995;32(Pt1):58–62. doi: 10.1177/000456329503200104. [DOI] [PubMed] [Google Scholar]
  • 24.Baggio B., Briani G., Cicerello E., Gambaro G., Bruttomesso D., Tiengo A. Urinary glycosaminoglycans, sialic acid and lysosomal enzymes increase in nonalbuminuric diabetic patients. Nephron. 1986;43(3):187–90. doi: 10.1159/000132319. [DOI] [PubMed] [Google Scholar]
  • 25.Agardh C.D., Tallroth G., Hultberg B. Urinary N-acetyl-beta-D-glucosaminidase activity does not predict development of diabetic nephropathy. Diabetes Care. 1987;10(5):604–6. doi: 10.2337/diacare.10.5.604. [DOI] [PubMed] [Google Scholar]
  • 26.Mungan N., Yuksel B., Bakman M., Topaloglu A.K., Ozer G. Urinary N-acetyl-beta-D-glucosaminidase activity in type I diabetes mellitus. Ind. Pediatr. 2003;40(5):410–4. [PubMed] [Google Scholar]

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