International Journal of General Medicine (Dec 2021)

Urinary N-Acetyl-β-d-Glucosaminidase (NAG) Levels and Risk of Cardiovascular Events in Diabetic Patients

  • Lou W,
  • Cheng Q,
  • Liang Y,
  • Xia D

Journal volume & issue
Vol. Volume 14
pp. 10495 – 10502

Abstract

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Weiwei Lou,1 Qun Cheng,1 Yanqiu Liang,1 Ding Xia2 1Department of Rehabilitation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China; 2Urology Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of ChinaCorrespondence: Ding XiaDepartment of Urology, Tongji Hospital, 1095 Jiefang Ave, Wuhan, Hubei, 430030, People’s Republic of ChinaTel +86 18177494319Email [email protected]: Cardiovascular diseases (CVDs) have a high incidence rate in population with diabetic patients. Studies on the association between urinary N-acetyl-β-d-glucosaminidase (NAG) levels, the biomarker of renal tubular damage, with cardiovascular (CV) events diabetic patients was still few.Methods: The relationship between urinary NAG levels and CV events was analyzed in a prospective cohort including 357 patients with type 2 diabetes mellitus at a follow-up of 5 years.Results: Twenty-six (7.3%) patients have CV events. Kaplan–Meier analysis suggested that diabetic patients with urine NAG levels ≥ 37.5 IU/L had a higher rate of CV events than those with urine NAG levels < 37.5 IU/L (Log rank test, P = 0.021). Cox analysis revealed that elevated urine NAG levels significantly contributed to increased risk of CV events (HR = 1.43, 95% CI 1.23– 1.93, P < 0.001) after adjusting for clinical confounding factors. Interestingly, we also found that “abnormal renal function” has an effect modification on the association between urine NAG levels and CV events. ROC-AUC analysis suggested that the urine NAG (AUC = 0.81, P < 0.001) had a better predictive value than eGFR (AUC = 0.74, P = 0.012).Conclusion: Elevated urine NAG levels are associated with higher risk of CV events in patients with type 2 diabetes. These results might further suggested that urinary NAG is a value urinary biomarker for early detecting CV events among diabetic patients.Keywords: N-acetyl-β-d-glucosaminidase, type 2 diabetes mellitus, cardiovascular event, diabetic nephropathy

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