1Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
3Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Copyright © 2018 Korean Diabetes Association
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Characteristic | All | Normal urinary NAG (≤5.8 U/g Cr) | High urinary NAG (>5.8 U/g Cr) | P value |
---|---|---|---|---|
Number | 1,061 | 431 | 630 | |
Demographic | ||||
Age, yr | 60.14±11.37 | 57.42±11.31 | 62.00±11.03 | <0.001 |
Male sex | 593 (55.61) | 268 (62.3) | 325 (51.6) | 0.002 |
BMI, kg/m2 | 25.03±3.68 | 25.39±3.39 | 24.78±3.85 | 0.009 |
Current smoker | 162 (15.27) | 70 (16.3) | 92 (14.6) | 0.487 |
Diabetes duration, yr | 8.33±7.56 | 6.94±6.78 | 9.28±7.91 | <0.001 |
Systolic blood pressure, mm Hg | 123.79±15.09 | 124.68±14.80 | 123.18±15.27 | 0.115 |
Diastolic blood pressure, mm Hg | 76.22±20.51 | 77.15±11.36 | 75.57±24.92 | 0.220 |
Glucometabolic parameter | ||||
Fasting glucose, mg/dL | 137.93±40.91 | 133.15±32.96 | 141.20±45.31 | 0.001 |
Stimulated glucose, mg/dL | 195.07±61.05 | 181.10±50.78 | 202.87±64.85 | <0.001 |
δ Glucose, mg/dL | 56.63±43.64 | 49.80±39.96 | 60.44±43.64 | 0.001 |
HbA1c, % | 7.26±1.27 | 7.04±1.05 | 7.41±1.38 | <0.001 |
Glycated albumin, % | 18.75±5.44 | 17.42±4.18 | 19.65±5.99 | <0.001 |
Glycated albumin to HbA1c | 2.55±0.43 | 2.45±0.36 | 2.62±0.47 | <0.001 |
Fasting C-peptide, ng/mL | 2.27±1.03 | 2.33±1.01 | 2.23±1.04 | 0.128 |
Stimulated C-peptide, ng/mL | 5.16±2.29 | 5.52±2.39 | 4.95±2.21 | 0.002 |
δ C-peptide, ng/mL | 2.83±1.81 | 3.13±1.94 | 2.67±1.71 | 0.001 |
HOMA-β | 42.07 (26.23–67.08) | 48.09 (31.71–74.74) | 39.09 (23.74–63.93) | <0.001 |
HOMA-IR | 2.59 (1.63–4.21) | 2.67 (1.71–4.18) | 2.58 (1.57–4.24) | 0.299 |
Nephropathic indice | ||||
eGFR, mL/min/1.73 m2 | 91.17±15.33 | 90.98±14.97 | 91.30±15.59 | 0.736 |
Urinary NAG, U/g creatinine | 6.66 (4.44–10.47) | 3.99 (2.82–4.96) | 9.48 (7.38–13.51) | <0.001 |
Urinary ACR, mg/g | 7.59 (4.54–12.47) | 6.16 (4.04–10.03) | 8.68 (5.31–14.65) | <0.001 |
Biochemistry profile | ||||
Albumin, mg/dL | 4.35±0.31 | 4.43±0.28 | 4.29±0.31 | <0.001 |
Total cholesterol, mg/dL | 160.57±37.02 | 157.69±34.89 | 162.55±38.31 | 0.036 |
Triglyceride, mg/dL | 112 (80–158.25) | 113.5 (80–157) | 111 (80–159.75) | 0.977 |
HDL-C, mg/dL | 49.81±13.69 | 50.68±14.39 | 49.22±13.16 | 0.090 |
LDL-C, mg/dL | 79.07±33.19 | 74.24±31.73 | 82.38±33.79 | <0.001 |
Antidiabetic drug | ||||
Insulin | 132 (12.44) | 46 (10.7) | 86 (13.7) | 0.156 |
Metformin | 818 (77.10) | 325 (75.4) | 493 (78.3) | 0.298 |
DPP-4 inhibitor | 542 (51.08) | 206 (47.8) | 336 (53.3) | 0.080 |
Thiazolidinedione | 61 (5.7) | 13 (3) | 48 (7.6) | 0.002 |
Sulfonylurea | 340 (32.05) | 113 (26.2) | 227 (36) | 0.001 |
Diuretics | 57 (5.37) | 24 (5.6) | 33 (5.2) | 0.890 |
ACE inhibitor or ARB | 326 (30.73) | 141 (32.7) | 185 (29.4) | 0.278 |
Parameter | Urinary NAG/Cr, U/g creatininea | |
---|---|---|
r | P value | |
Age, yr | 0.227 | <0.001 |
Body mass index, kg/m2 | −0.069 | 0.025 |
Fasting glucose, mg/dL | 0.124 | <0.001 |
Stimulated glucose, mg/dL | 0.185 | <0.001 |
Fasting C-peptide, ng/mL | 0.001 | 0.974 |
Stimulated C-peptide, ng/mL | −0.115 | 0.002 |
δ C-peptide, nmol/L | −0.153 | <0.001 |
Glycated albumin, % | 0.259 | <0.001 |
HbA1c, % | 0.197 | <0.001 |
HOMA-βa | −0.060 | 0.098 |
HOMA-IRa | 0.029 | 0.423 |
Urinary ACR, mg/ga | 0.233 | <0.001 |
eGFR, mL/min/1.73 m2 | 0.044 | 0.154 |
Variable | Model 1a | Model 2b | Model 3c | |||
---|---|---|---|---|---|---|
STD β | P value | STD β | P value | STD β | P value | |
Glycated albumin, % | 0.276 | <0.001 | 0.217 | 0.014 | 0.213 | 0.016 |
HbA1c, % | −0.002 | 0.968 | −0.135 | 0.096 | −0.137 | 0.096 |
Fasting glucose, mg/dL | - | - | −0.003 | 0.962 | 0.006 | 0.930 |
Stimulated glucose, mg/dL | - | - | 0.100 | 0.115 | 0.095 | 0.140 |
Stimulated C-peptide, ng/mL | - | - | 0.176 | 0.103 | 0.152 | 0.171 |
δ C-peptide, ng/mL | - | - | −0.226 | 0.028 | −0.206 | 0.050 |
Values are presented as mean±standard deviation, number (%), or median (interquartile range). NAG, N-acetyl-β-d-glucosaminidase; BMI, body mass index; HbA1c, glycosylated hemoglobin; HOMA-β, homeostasis model assessment of β-cell; HOMA-IR, homeostasis model assessment of insulin resistance; eGFR, estimated glomerular filtration rate; ACR, albumin-to-creatinine ratio; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; DPP-4, dipeptidyl peptidase-4; ACE, angiotensin converting enzyme; ARB, angiotensin receptor blocker.
NAG, N-acetyl-β-d-glucosaminidase; Cr, creatinine; r, correlation coefficient; HbA1c, glycosylated hemoglobin; HOMA-β, homeostasis model assessment of β-cell; HOMA-IR, homeostasis model assessment of insulin resistance; ACR, albumin-to-creatinine ratio; eGFR, estimated glomerular filtration rate. aLog transformed form.
Logarithm-transformed values of urinary NAG were used for analysis. NAG, N-acetyl-β-d-glucosaminidase; STD β, standardized β coefficient; HbA1c, glycosylated hemoglobin. aModel 1: adjusted age, sex, body mass index, diabetes duration, and current smoking, bModel 2: model 1+further adjusted fasting glucose, stimulated glucose, stimulated C-peptide, δ C-peptide, estimated glomerular filtration rate, low density lipoprotein cholesterol, albumin, and urinary albumin-to-creatinine ratio (log transformed), cModel 3: model 2+further adjusted sulfonylurea use, insulin use, angiotensin converting enzyme inhibitor or angiotensin receptor blocker use, and diuretics use.