Endocrine Abstracts

The work was initiated to assess clinical-diagnostic value of urinary α-glucosidase activity in predicting chronic renal insufficiency in type 1 diabetes mellitus in Uzbek children and adolescents. We examined 152 children and adolescents of the Uzbek population, 122 children and adolescents with type 1 diabetes mellitus (51 male and 71 female). By proteinuria the patients were divided into three groups: with normoalbuminuria (NAU) (n=52), with microalbuminuria (MAU) (n=50) and marked proteinuria (MPU) (n=20). 30 children and adolescents of matched age and sex were included into the control group. The urinary neutral α-glucosidase activity was measured by rate of glucose formation from maltose. In Uzbek children and adolescents with type 1 diabetes mellitus high incidence of D-allele was observed as diabetic nephropathy progressed. II Genotype was registered in 41.5% of cases on the MAU stage, but no cases were observed on MOU stage to be the evidence for high protection of the ACE gene genotype in chronic renal insufficiency progression and consistent with data of studies conducted in other ethnic populations. For the first time the study on interconnection between activity of urinary neutral α-glucosidase activity and ACE gene genotype was performed. It was established that urinary neutral α-glucosidase activity depended not only on diabetic nephropathy (DN) severity, but on all DN stages in persons with ID and DD genotype it was confidently higher than in those with II genotype. That is the activity of the enzyme was turned out genetically determined by ACE gene. The findings broaden diagnostic opportunities in assessment of urinary neutral α-glucosidase activity not only in early diagnosing of pre-clinical DN in children and adolescents with type 1 diabetes mellitus, but also in predicting progression of terminal DN stages in patients with high susceptibility to chronic renal insufficiency. Registration of increase in the urinary neutral α-glucosidase in children and adolescents with type 1 diabetes mellitus on the pre-MAU stage as a marker of early pre-clinical DN stage will allow solving problem of identification of a group with confidently high DN predicting and progression risk as well as preventive therapy of the complication in question.