The Correlation of Urine Retinol Binding Protein-4 and Serum HbA1c with Glomerular Filtration Rate in Type 1 (Insulin-Dependent) Diabetic Children: A Perspective on the Duration of Diabetes

Edy Novery^*, Susi Susanah, Dedi Rachmadi

Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.

DOI: 10.4236/ojped.2015.52020                

Abstract

Objective: To analyze the correlation between urine retinol binding protein-4 (RBP-4) and serum HbA_1c with glomerular filtration rate (GFR) in type 1 diabetic children. Methods: This was a crosssectional observational analytic study. The subjects were type 1 diabetic children aged 2 - 14 years. Sample collection was conducted from October to November 2014. Exclusion criteria were patients with obesity, renal insufficiency that was not caused by diabetes, history of hepatic diseases, and history of blood cell disorders. We performed anamnesis, physical examination, and blood sampling for serum HbA_1c and serum cystatin-C, and urine sampling for RBP-4 on all subjects. Glomerular filtration rate was calculated from the concentration level of cystatin-C using Filler formula. Data analysis was performed by Spearman test to determine the correlation between urine RBP-4 and serum HbA_1c with GFR. The Fisher’s exact test was used to determine the correlation between duration of diabetes and RBP-4, HbA_1c, and also GFR. Results: Twelve females (60%) and 8 males (40%) participated in the study. The mean age of the subjects with 95% CI was: 10.5 (2 - 14) years while the mean age of duration diabetes with 95% CI: 3.8 (0.5 - 10) years. Twelve (60%) subjects had <5 years duration of diabetes, while eight (40%) subjects had ≥5 years duration of diabetes. Twelve (60%) subjects had normal RBP-4 level, while eight (40%) subjects had elevated RBP-4 level. The mean level of HbA_1c with 95% CI: 8.9 (5.1 - 15.2)%. Thirteen (65%) subjects had poor metabolic. The mean GFR of the subjects with 95% CI: 99.3 (35.2 - 147.4) mL/1.73/m². Nineteen (95%) subjects had normal GFR, while 1 (5%) had renal insufficiency. The results of data analysis using Spearman test on the correlation between urine RBP-4 and serum HbA_1cwith GFR were not significant. The result of correlation between duration of diabetes and urine RBP-4 was significant using Fischer’s test. Conclusion: The results showed no correlation between urine RBP-4 and serum HbA_1c with GFR. Urine RBP-4 could be considered to assess renal function in type 1 diabetic patients with a duration of diabetes of more than 5 years.

Keywords

RBP-4, HbA1c, Glomerular Filtration Rate, Diabetes, Children

Conflicts of Interest

The authors declare no conflicts of interest.

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