Serum sialic acid concentration as a useful biochemical marker for early detection of nephropathy in insulin dependent diabetic children

ABSTRACT

Elevated serum sialic acid concentration is a strong predictor of cardiovascular morbidity in non-diabetic subjects. Because patients with insulin dependent diabetes mellitus [IDDM] and albuminuria have a highly increased cardiovascular morbidity and mortality, this study hypothesized that IDDM patients with albuminuria would have an increased concentration of serum sialic acid. One hundred children and adolescents were selected and divided into a diabetic group [n-75] and a healthy control group [n=25]. The diabetic group was further subdivided into three IDDM groups according to the duration of diabetes. Serum sialic acid, fasting blood sugar, HbAIc, creatinine, and urea were assayed in the blood. Microalbumi-nuria was assayed in urine. The mean value of total serum sialic acid concentration, fasting blood glucose HbAIc, were significantly increased in diabetic group when compared with control group [P<0.001]. Also microalbuminuria in urine as AER was significantly increased when compared with the control group [P< 0.001]. An increased serum sialic acid concentration is found to be predictive for the onset of microalbuminuria. There was a significantly positive correlation between total serum sialic acid, microalbuminuria and fasting blood glucose in the diabetic group. There was highly significant positive correlation between the mean value of sialic acid and albumin / creatinine ratio in group II and III diabetic children. Early detection of diabetic children who are prone to develop diabetic nephropathy is of utmost clinical importance and raised serum sialic acid could be used as a useful biochemical marker for early detection of diabetic nephropathy in children