URINARY ACIDIC GLYCOHYDROLASE AS AN INDEX OF EARLY RENAL DAMAGE IN JUVENILE DIABETES MELLITUS (JDM)

Abstract

Acidic glycohydrolases involved in the degradation of glyeoprotein are present in small amounts in normal urines, but increase 4-fold in active renal diseases in children. To assess early renal involvement in JDM, Addis counts (timed urinary cell excretions), quantitative proteinuria, creatinine clearance, urinary acidic glycohydrolases, B-galactosidase (B-galase), B-N-hexosaminidase (B-hexase), and plasma acidic glycohydrolases, α-galactosidase, B-galase, B-hexase, α-mannosidase (α-mannase), α-fucosidase, were studied in 110 JDM children aged 3-16 years. Urinary B-galase and B-hexase was significantly higher in JDM than in normals, but lower than in children with active renal disease. Urinary B-galase, B-hexase had no correlation to urinary RBC's, WBC's, protein and sugar, but significantly correlated to plasma trlglycerides, age of the child, and duration of JDM (p<0.01). Of the plasma glycohydrolase, B-hexase and α-mannase correlated to blood sugar, cholesterol, triglycerides and to age of the child and duration of JDM (p<0.01). Six hours after insulin, mean urinary B-galase and B-hexase in 18 children returned to near normal levels. These data suggest that both urinary and plasma acidic plycohydrolases may be used as an index of Glycoprotein catabolism and hence early renal involvement in JDM.

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