ESPE Abstracts

Aim: To identify clinical significance of enzymuria in early diagnosis of DN in children and adolescents with type 1 diabetes mellitus.

Materials and methods: We examined 112 patients (47males/55 females) with type 1 diabetes mellitus. By the DN severity the patients were divided into following groups: with normoalbuminuria (NAU) (n=47), with microalbuminuria (MAU) (n=44) and with marked proteinuria (MP) (n=19). Ten healthy subjects of the same age were included into the control group. Activity of neutral urinary alfa-glucosidase (alfa-GL) was measured by intensity of glucose formation from maltose after its incubation in potassium phosphate buffer containing 0.2 mmol/l of maltose at 37°C.

Results and discussion: The study showed confident increase in the urinary protein level with DN progression. As compared with the NAU persons there was a 6-time increase of the urinary protein in patients with MAU (13.6±0.7 vs 77±9.5), in patients with MP the protein increase being 32 times higher as compared with those with NAU (13.6±0.7 vs 416.8±50.78). In patients with NAU prior to MAU appearance activity of neutral alfa-GL confidently increases by 36 times (0.01±0.032 vs 0.52±0.041), in patients with MAU there was a 1.5-time increase as compared with NAU persons (0.36±0.032 vs 0.52±0.041), in the group with MP the parameter increasing by 1.2 times as compared with the patients having MAU (0.52±0.041 vs 0.61±0.04).

Conclusions: In children and adolescents with type 1 diabetes mellitus increase in the activity of the urinary neutral alfa-glucosidase was established associating with disturbance of both renal tubular and glomerular apparatuses to correlate with the proteinuria and DN severity. As DN severity enhances the activity of the urine neutral alfa-GL is shown to increase. An early marker in DN diagnosis activity of the urinary neutral alfa-GL is found diagnostically significant at the early stages of diabetes mellitus progression.