{"title":"The NGAL as a prognostic biomarker of kidney injury in children and adolescents with type 1 diabetes mellitus: A systematic review and meta-analysis","authors":"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","doi":"10.1016/j.jdiacomp.2025.109002","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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 <em>p</em> < 0.05 was considered statistically significant. A study quality assessment was conducted using the Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>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 (<em>r</em> = 0.53, 95 % CI [0.31–0.70]). The uNGAL revealed a high overall diagnostic accuracy (AUC = 0.881).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 5","pages":"Article 109002"},"PeriodicalIF":2.9000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of diabetes and its complications","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1056872725000558","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
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.
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.