Features of biochemical parameters in healthy and patients with type 1 diabetes mellitus with different levels of albumin in the urine

  • Yu. O. Kryvoviaz National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • V. S. Vernigorodskiy National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • Adarsh Kumar All India Institute of Medical Sciences, New Delhi, India
  • І. V. Dzevulska National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • V. I. Kyrychenko National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Keywords: type 1 diabetes mellitus, urinary albumin levels, biochemical parameters.

Abstract

The use of multi-label biochemical panels is justified by the fact that different markers reflect the severity of various pathological processes (disorders of carbohydrate and fat metabolism), which in their interaction are indicators of decompensation of a single pathology – diabetes in particular. The aim of the work was to study the differences in biochemical parameters in healthy and patients with type 1 diabetes mellitus (T1D) depending on the level of albumin in the urine. 78 men and 62 women aged 22-26 years, patients with diabetes mellitus type 1, who were hospitalized in the therapeutic department в № 1 and № 2 of Vinnytsia Regional Highly Specialized Endocrinology Center and 8 practically healthy men and 13 practically healthy women of the same age were examined. The level of microalbuminuria was determined in all patients by enzyme-linked immunosorbent assay. Fasting blood glucose and 2 hours after a meal were determined by enzymatic, amperometric analysis on a biochemical analyzer Biosen C_Line, manufactured by EKF Diagnostic (Germany). The average value of blood glucose was calculated mathematically. To determine glycated hemoglobin (HbA1c), we used the method of high performance liquid chromatography on a D 10 analyzer, manufactured by Bio-Rad (USA). The International Normal Ratio (INR) was determined using a set of reagents to determine the prothrombin time, prothrombin ratio and international sensitivity index, which is specified in the passport to the set (manufacturer of PC-K-TEST "Granum"). Total cholesterol and triglycerides were determined by colorimetric photometric method (using enzymes) on a biochemical analyzer using standard kits from Olympus AU480 (USA). Statistical processing of the results was performed in the license package "Statistica 5.5", using non-parametric evaluation methods. When comparing the level of biochemical parameters between patients with T1D and normo-, microalbuminuria and proteinuria with healthy men or women, patients found higher values: fasting glucose (in men – by 29.1 %, 30.9 % and 42.0 %; in women – by 29.7 %, 33.2 % and 46.0 %); glucose 2 hours after exercise (for men – by 27.4 %, 30.8 % and 36.1 %; for women – by 30.4 %, 32.4 % and 40.2 %); the average value of glucose (for men – by 26.2 %, 30.8 % and 39.3 %; for women – by 28.7 %, 34.0 % and 43.1 %); glycated hemoglobin (47.8 %, 48.8 % and 45.8 % for men; 27.2 %, 50.2 % and 54.4 % for women). Also, in patients with T1D men and proteinuria and women with normoalbuminuria and proteinuria compared with healthy men or women found higher cholesterol values (17.8 % in men and 7.6 % and 26.0 % in women); and in patients with T1D men with proteinuria compared to healthy men – 31.3 % higher triglyceride levels. When comparing the level of biochemical parameters between patients with T1D in men or women with proteinuria, higher values were found: fasting glucose compared with men with normoalbuminuria by 22.2 % and with women with normoalbuminuria by 30.3 % and microalbuminuria by 23.7 %; the average value of glucose compared with men with normoalbuminuria by 20.8 % and microalbuminuria by 14.0 %; glycated hemoglobin compared to women with normoalbuminuria by 15.9 %; compared with men with normoalbuminuria and microalbuminuria – by 24.8 % and 20.3 %, or with women with normoalbuminuria and microalbuminuria – by 24.9 % and 28.0 %; triglycerides compared with men with normoalbuminuria by 23.0 %. When comparing the sex differences in the level of biochemical parameters between healthy or between patients with T1D and normo-, microalbuminuria and proteinuria in men and women, only higher values of glycated hemoglobin by 14.1 % in women with proteinuria and total cholesterol by 8.3 % in women with normoalbuminuria were found. Thus, between healthy and patients with T1D and different levels of albuminuria there are differences in biochemical parameters, and they are greater the higher the level of albumin in the urine.

Downloads

Download data is not yet available.

References

[1] Bennett, P. H., Lee, E. T., Lu, M., Keen, H., & Fuller, J. H. (2001). Increased urinary albumin excretion and its associations in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia, 44(2), S37-S45. doi: 10.1007/pl00002938
[2] Chawla, A., Chawla, R., & Jaggi, S. (2016). Microvascular and macrovascular complications in diabetes mellitus: distinct or continuum?. Indian journal of endocrinology and metabolism, 20(4), 546-551. doi: 10.4103/2230-8210.183480
[3] Chumakova, G. A., Veselovskaya, N. G., Gritsenko, O. V., & Ott, A. V. (2014). Метаболический синдром: сложные и нерешенные проблемы [Metabolic syndrome: challenging and unresolved issues]. Российский кардиологический журнал – Russian Journal of Cardiology, (3 (107)), 63-71. doi: 10.15829/1560-4071-2014-3-63-71
[4] De Boer, I. H., Rue, T. C., Cleary, P. A., Lachin, J. M., Molitch, M. E., Steffes, M. W., ... & Brunzell, J. D. (2011). Long-term renal outcomes of patients with type 1 diabetes mellitus and microalbuminuria: an analysis of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications cohort. Archives of internal medicine, 171(5), 412-420. doi: 10.1001/archinternmed.2011.16
[5] Dedov, I. I. (2012). Сахарный диабет: острые и хронические осложнения [Diabetes mellitus: acute and chronic complications]. Москва: МИА – Moscow: MIA.
[6] Farmer, A., Stevens, R., & Hirst, J. (2014). Optimal strategies for identifying kidney disease in diabetes: properties of screening tests, progression of renal dysfunction and impact of treatment-systematic review and modelling of progression and cost-effectiveness. Health technology assessment (Winchester, England), 18(14), 1-128. doi: 10.3310/hta18140
[7] Forbes, J. M., Cooper, M. E., Oldfield, M. D., & Thomas, M. C. (2003). Role of advanced glycation end products in diabetic nephropathy. Journal of the American Society of Nephrology, 14(suppl 3), S254-S258. doi: 10.1097/01.asn.0000077413.41276.17
[8] Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., ... & Costa, F. (2005). Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation, 112(17), 2735-2752. doi: 10.1161/CIRCULATIONAHA.105.169404
[9] Harding, J. L., Pavkov, M. E., Magliano, D. J., Shaw, J. E., & Gregg, E. W. (2019). Global trends in diabetes complications: a review of current evidence. Diabetologia, 62(1), 3-16. doi: 10.1007/s00125-018-4711-2
[10] Kaplanian, M. V., Vorokhobina, N. V., & Riasnianskii, V. Iu. (2016). Предикторы диабетической нефропатии у больных сахарным диабетом 1 типа [Predictors of diabetic nephropathy in patients with type 1 diabetes mellitus]. Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова – Bulletin of the North-Western State Medical University named after I.I. Mechnikov, 8(2), 38-43.
[11] Kern, E. F., Erhard, P., Sun, W., Genuth, S., & Weiss, M. F. (2010). Early urinary markers of diabetic kidney disease: a nested case-control study from the Diabetes Control and Complications Trial (DCCT). American Journal of Kidney Diseases, 55(5), 824-834. doi: 10.1053/j.ajkd.2009.11.009
[12] Korolov, V. O., Glushkova, O. V., & Repinska, N. (2009). Клініко-лабораторне тлумачення діабетичної нефропатії [Clinical and laboratory interpretation of diabetic nephropathy]. Клінічна ендокринологія та ендокринна хірургія – Clinical endocrinology and endocrine surgery, (1 (26)), 30-34.
[13] Lanaspa, M. A., Ishimoto, T., Cicerchi, C., Tamura, Y., Roncal-Jimenez, C. A., Chen, W., ... & Johnson, R. J. (2014). Endogenous fructose production and fructokinase activation mediate renal injury in diabetic nephropathy. Journal of the American Society of Nephrology, 25(11), 2526-2538. doi: 10.1681/ASN.2013080901
[14] Leonova, N. V., Chumakova, G. A., Tsirikova, A. V., & Pushkareva S. V. (2015). Влияние метаболического синдрома на риск развития осложнений сахарного диабета типа 1 [The influence of metabolic syndrome on the risk of 1st type diabetes complications development]. Российский кардиологический журнал – Russian Journal of Cardiology, (4 (120)), 55-58. doi: 10.15829/1560-4071-2015-4-55-58
[15] Lim, A. K. (2014). Diabetic nephropathy–complications and treatment. International journal of nephrology and renovascular disease, 7, 361-381. doi: 10.2147/IJNRD.S40172
[16] Litvin, A. (2011). Микроальбуминурия: клиническое значение [Microalbuminuria: clinical value]. Врач – Doctor, (9), 7-13.
[17] Polozova, E. I., Sorokina, N. N., Puzanova, E. V., & Seskina, A. A. (2019). Роль метаболических нарушений в прогрессировании ренальной дисфункции у больных метаболическим синдромом и артериальной гипертензией [The role of metabolic disorders in the progression of renal dysfunction in patients with metabolic syndrome and arterial hypertension]. Медицинский совет – Medical Council, (6), 170-175. doi: 10.21518/2079-701X-2019-6-170-175
[18] Velkov, V. V. (2012). Диабетическая нефропатия в трех измерениях: гиперфильтрация, альбумин, креатинин [Diabetic nephropathy in three dimensions: hyperfiltration, albumin, creatinine]. Лабораторная диагностика – Laboratory diagnostics, 4(62), 50-72.
Published
2020-10-29
How to Cite
Kryvoviaz, Y. O., Vernigorodskiy, V. S., Kumar, A., DzevulskaІ. V., & Kyrychenko , V. I. (2020). Features of biochemical parameters in healthy and patients with type 1 diabetes mellitus with different levels of albumin in the urine. Biomedical and Biosocial Anthropology, (39), 23-28. https://doi.org/10.31393/bba39-2020-04