Investigation On The Reference Intervals And Clinical Applications Of Urine α1-MG

Objective:α1-MG is a reliable and sensitive marker for the damage of proximal renal tubule reabsorption.Though stable performance and good reproducibility,no unified normal reference range limits its clinical application.The purpose of this study is:（1）to explore the linear relationship between the level of urineα1-MG and other clinical indicators in healthy population;（2）try to establish the normal reference range of urineα1-MG according to the previous analysis;（3）to investigate the effect of blood glucose compliance on proximal renal tubular reabsorption function in T2DM.Methods:1.Screening 299 persons（141 men and 158 women）aged 20-60 years old from Tianjin Union Medical Center,collected their basic information and blood,urine specimens,detected fasting blood glucose,blood lipid,blood creatinine and so on,and calculated the eGFR according to the 2009 CKD-EPI creatinine equation;detect urineα1-MG and creatinine concentration,and calculateα1-MG/Cr.The correlation between urineα1-MG level and age,sex and other indicators was analyzed.2.According to previous results,484 cases（121 cases of each age of men and women）were screened from 1957 physical examiners.The basic information and blood,urine samples were collected,eGFR was calculated,the urinaryα1-MG and urinary creatinine concentration were detected,andα1-MG/Cr was calculated.Z test was used to compare the difference ofα1-MG level between different groups,and the corresponding reference intervals were established according to the results of Z test.3.Of the 259 hospitalized T2DM patients,149 cases were selected with 50matched controls.The concentrations of HbA₁c,urinaryα1-MG,urinary creatinine were measured,and urineα1-MG/Cr was calculated.According to the level of HbA1c,diabetic patients were divided into two groups:standard group within glycemic control（HbA₁c<7%）and the non standard group（HbA₁c>7%）.The difference of renal function between the two groups was analyzed.Results:1.After multifactor analysis,only sex and eGFR remained related toα1-MG.while the correlation betweenα1-MG/Cr and sex and age was statistically significant in single and multi factor regression analysis.In male,the level ofα1-MG/Cr in the20-30 year old group was lower than 51-60 group,while in female,the level ofα1-MG/Cr 20-30 group was significantly lower than the other three groups.2.The results of Z test were as follows:（1）there was significant difference ofα1-MG andα1-MG/Cr level between male and female;（2）There was no significant difference in the level of urinaryα1-MG/Cr in male,but in female groups,theα1-MG/Cr in the 30⁶0 age group was significantly higher than the 20³0 age group.3.There was no significant difference in urinaryα1-MG andα1-MG/Cr between the two groups within and without glycemic control standard,no significant difference in the proportion of increase,too.However,through theα1-MG box diagram,it was significant that the protein peak of the non-strict control group was higher than the strict control group.Conclusions:1.In healthy people aged 20⁶0 years old,the urineα1-MG depends only on sex and is not related to age.The urineα1-MG/Cr level is related to gender and age.There are significant differences in urine levels before and after 30 years of age.The normal reference interval ofα1-MG/Cr needs to considere sex and age.2.The reference range of urineα1-MG existing gender difference is,in males:0-26.76 mg/L;in females:0-9.75 mg/L.There are gender and age differences in the reference interval ofα1-MG/Cr,for males is:0-20.71mg/g for 20-60 years;for females is:0-22.72 mg/g for 20-30 year old,0-28.28 mg/g for 31-60 year old.3.Investigated the effect of blood glucose level on urinaryα1-MG level in Chinese T2DM for the first time.Although the results showed the difference was not significant,the increasing trend of urinaryα1-MG levels in the bad control group is still suggesting that clinicians should strengthen the health education for T2DM patients and increase their awareness of blood glucose control.