The NGAL as a prognostic biomarker of kidney injury in children and adolescents with type 1 diabetes mellitus: A systematic review and meta-analysis

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2025-03-22 DOI:10.1016/j.jdiacomp.2025.109002

Nikolaos Gkiourtzis , Anastasia Stoimeni , Panagiota Michou , Konstantinos Cheirakis , Maria Moutafi , Aristeidis Christakopoulos , Agni Glava , Paraskevi Panagopoulou , Georgios Tsigaras , Assimina Galli-Tsinopoulou , Athanasios Christoforidis , Despoina Tramma

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引用次数: 0

Abstract

Aims

A major complication of type 1 diabetes is diabetic kidney disease (DKD). Albuminuria and impaired glomerular filtration rate are the main characteristics of DKD. Neutrophil gelatinase-associated lipocalin (NGAL) levels may rise even in the early stages of DKD, even in patients with normoalbuminuria. We present the first systematic review and meta-analysis examining the prognostic role of NGAL exclusively in pediatric patients with type 1 diabetes.

Methods

A search through major databases was carried out until September 24, 2024, investigating the prognostic role of NGAL in kidney injury in pediatric patients with type 1 diabetes. A p < 0.05 was considered statistically significant. A study quality assessment was conducted using the Newcastle-Ottawa Scale.

Results

The standardized mean difference in urinary NGAL (uNGAL) levels between the type 1 diabetes group and healthy controls was statistically significant (SMD = 0.63, 95%CI [0.36,0.90]). A moderate positive relationship between uNGAL and ACR was identified (r = 0.53, 95 % CI [0.31–0.70]). The uNGAL revealed a high overall diagnostic accuracy (AUC = 0.881).

Conclusions

Urinary NGAL appears to be a valuable biomarker for early detection and understanding of DKD in individuals with type 1 diabetes. Future clinical studies should prioritize assessing the accuracy of NGAL in identifying kidney injury in pediatric patients with type 1 diabetes and the association of NGAL with traditional biomarkers in groups with similar characteristics.

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NGAL作为儿童和青少年1型糖尿病患者肾损伤的预后生物标志物：一项系统综述和荟萃分析

1型糖尿病的主要并发症是糖尿病肾病（DKD）。蛋白尿和肾小球滤过率受损是DKD的主要特征。中性粒细胞明胶酶相关脂钙蛋白（NGAL）水平甚至在DKD的早期阶段也可能升高，甚至在正常蛋白尿患者中也是如此。我们提出了第一个系统综述和荟萃分析，专门研究NGAL在儿科1型糖尿病患者中的预后作用。方法检索主要数据库至2024年9月24日，探讨NGAL在1型糖尿病患儿肾损伤中的预后作用。A & p；0.05认为有统计学意义。采用纽卡斯尔-渥太华量表进行研究质量评估。结果1型糖尿病组与健康对照组尿NGAL （uNGAL）水平的标准化均值差异有统计学意义（SMD = 0.63, 95%CI[0.36,0.90]）。uNGAL与ACR呈正相关（r = 0.53, 95% CI[0.31-0.70]）。uNGAL显示出较高的总体诊断准确率（AUC = 0.881）。结论尿NGAL是1型糖尿病患者早期检测和了解DKD的有价值的生物标志物。未来的临床研究应优先评估NGAL识别1型糖尿病儿童肾损伤的准确性，以及在具有相似特征的人群中NGAL与传统生物标志物的关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.