Levels of urinary matrix metalloproteinase‐9 (MMP‐9) and renal injuries in patients with type 2 diabetic nephropathy

摘要

To determine correlations among the levels of urinary MMP‐9 and type‐IV collagen, hyperglycemia, urinary protein excretion, and renal injuries in patients with type 2 diabetic nephropathy, we measured levels of urinary MMP‐9 and protein, blood urea nitrogen (BUN), serum creatinine (s‐Cr), fasting plasma glucose (FPG), and glycohemoglobin A1c (HbA1c) in 47 diabetic patients and 14 healthy adults. Urinary type‐IV collagen was also measured in 28 diabetic patients and seven healthy adults. Patients with diabetic nephropathy were divided into two groups: 1) patients with normoalbuminuria or microalbuminuria (0–299 mg/g·Cr; n=27), and 2) patients with macroalbuminuria (>300 mg/g·Cr; n=20). The mean level of urinary MMP‐9 in group 2 was significantly higher than those in healthy adults ( <0.05), and the levels of urinary MMP‐9 in patients with diabetic nephropathy increased in accordance with the clinical stage of the disease. The levels of urinary MMP‐9 tended to be correlated with HbA1c in these patients, but the correlation was not statistically significant. The mean level of urinary type‐IV collagen in group 2 of patients with diabetic nephropathy was significantly higher than that in group 1 and healthy adults. Levels of urinary type‐IV collagen in patients with diabetic nephropathy also increased in accordance with the clinical stage of the disease. The results suggest that measurements of urinary MMP‐9, as well as urinary type‐IV collagen, may be useful for evaluating the degree of renal injuries in patients with type 2 diabetic nephropathy, especially in the early stage. J. Clin. Lab. Anal. 18:206–210, 2004. © 2004 Wiley‐Liss, Inc.