Association between ALP and GGT levels with glomerular filtration rate in diabetic patients

Siriporn Patrakitkomjorn, Sirawich Sonsok, Yaovalak Teerajetgul, Limthong Promdee, Tanakorn Proungvitaya

Abstract


Complication in diabetes mellitus can cause abnormalities in several organs such as kidneys, eyes, bone, pancreas, heart, brain, intestine and etc. Tissue damage in one organ can effect to particular enzymes that involves in its function. Apart from enzyme, protein in urine is also an indicator of renal damage. Microalbuminuria can be detected in more than 40 percent of diabetic patients. In the present study, 6 kinds of enzymes that found in kidneys including AST, ALT, GGT, ALP, CK and LDH were determined and compared the pattern of each enzyme levels between diabetic patients and control group. The data of essential parameters e.g. age, BMI, serum creatinine and eGFR were collected and analyzed. It was found that age, BMI, serum creatinine, ALP, LDH and eGFR were significant difference between diabetic patients and control group (p<0.05). In diabetic patients with renal damage as indicated by serum creatinine, eGFR and urine albumin to creatinine ratio (UACR) showed abnormal increase in ALP and GGT levels. The patterns of enzymes levels and other parameters in 5 stages of renal insufficiency based on eGFR of 75 diabetic patients were compared. ALP, GGT and UACR gave the similar patterns during stage 2 to 5. However, only ALP showed gradual increase during stage 1 to 2. The concordance between ALP level and eGFR during the progression of the disease in stage 1 was found. In addition, ALP level lesser than 100 U/L can indicate early stage of renal damage. Conversely, ALP level greater than 100 U/L usually reflects severe renal damage.

. In conclusion, the patterns of ALP, GGT levels and UACR are concordance with eGFR during stage 2 to 5. The ALP level found increasing in early stage of renal insufficiency. This might be useful for early detection and estimation of renal damage in diabetes mellitus.


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