Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: RESULTS: The A- megalin assay mainly detected a megalin ectodomain form in the soluble urinary fraction, whereas the C- megalin assay identified a full-length form in both soluble and insoluble fractions. Urinary C- megalin levels were significantly high in patients with normoalbuminuria, were elevated in line with increased albuminuria, and showed a better association with estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73 m(2)) than did urinary albumin. In contrast, urinary A- megalin levels were increased in patients with normo- and microalbuminuria but not in those with macroalbuminuria. Urinary C- megalin levels were also positively associated with plasma inorganic phosphate and negatively with hemoglobin levels in those showing no features of bleeding and not taking vitamin D analogs, phosphate binders, or erythropoiesis-stimulating agents. CONCLUSIONS: Urinary full-length megalin excretion as measured by the C- megalin assay is well associated with reduced eGFR and linked to the severity of DN, phosphate dysregulation, and anemia, whereas urinary excretion of megalin ectodomain as measured by the A- megalin assay may be associated with distinctive mechanisms of earlier DN in type 2 diabetes.
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Authors | Shinya Ogasawara, Michihiro Hosojima, Ryohei Kaseda, Hideyuki Kabasawa, Keiko Yamamoto-Kabasawa, Hiroyuki Kurosawa, Hiroyoshi Sato, Noriaki Iino, Tetsuro Takeda, Yoshiki Suzuki, Ichiei Narita, Kunihiro Yamagata, Yasuhiko Tomino, Fumitake Gejyo, Yoshiaki Hirayama, Sakari Sekine, Akihiko Saito |
Journal | Diabetes care
(Diabetes Care)
Vol. 35
Issue 5
Pg. 1112-8
(May 2012)
ISSN: 1935-5548 [Electronic] United States |
PMID | 22410816
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Low Density Lipoprotein Receptor-Related Protein-2
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Topics |
- Adult
- Aged
- Diabetes Mellitus, Type 2
(metabolism, urine)
- Enzyme-Linked Immunosorbent Assay
- Female
- Glomerular Filtration Rate
(physiology)
- Humans
- Kidney
(metabolism)
- Low Density Lipoprotein Receptor-Related Protein-2
(metabolism)
- Male
- Middle Aged
- Young Adult
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