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α₁-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients

Charline Wehlou (UGent) , Marijn Speeckaert (UGent) , Tom Fiers (UGent) , Marc De Buyzere (UGent) and Joris Delanghe (UGent)
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Abstract
Background: Statins can cause tubular proteinuria by inhibiting tubular reabsorption of urinary proteins. To distinguish between microalbuminuria originating from glomerular leakage of albumin and tubular microalbuminuria due to statin therapy, the alpha(1)-microglobulin/albumin ratio is evaluated in patients taking statins and compared to untreated patients. Methods: Ten apparently healthy subjects were given 40 mg of simvastatin and tested for urinary alpha(1)-microglobulin, albumin, creatinine and cystatin C, up to 24 h after administration. Additionally, urine samples of 76 statin-treated and 456 untreated patients presenting with micro-albuminuria (albuminuria range between 20 and 200 mg/L) were tested for alpha(1)-microglobulin and albumin. alpha(1)-Microglobulin/albumin ratios were compared. Total cholesterol was measured in 50 patients on statin therapy. Results: In the 10 apparently healthy subjects, a significant temporary increase of alpha(1)-microglobulin, albumin and alpha(1)-microglobulin/albumin ratio was observed after statin intake. In the group of 532 patients showing microalbuminuria, those treated with statins showed a significantly higher mean urinary alpha(1)-microglobulin/albumin ratio then untreated patients. Urinary albumin concentrations were significantly higher in patients taking simvastatin than in patients on rosuvastatin treatment and they were also higher in patients on statin therapy with a total serum cholesterol concentration below 3.88 mmol/L than in patients with a total serum cholesterol concentration above 5.17 mmol/L. Conclusions : Tubular proteinuria, caused by the use of statins, can be distinguished from glomerular proteinuria by a higher urinary alpha(1)-microglobulin/albumin ratio.
Keywords
MEGALIN, RECEPTOR-MEDIATED ENDOCYTOSIS, PROTEIN, INHIBITORS, HEMATURIA, PATHWAY, COMPLEX, CUBILIN, GTPASES, URINE, statins, proteinuria, alpha(1)-microglobulin, albumin

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MLA
Wehlou, Charline et al. “α₁-Microglobulin/albumin Ratio May Improve Interpretation of Albuminuria in Statin-treated Patients.” CLINICAL CHEMISTRY AND LABORATORY MEDICINE 51.7 (2013): 1529–1534. Print.
APA
Wehlou, C., Speeckaert, M., Fiers, T., De Buyzere, M., & Delanghe, J. (2013). α₁-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients. CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 51(7), 1529–1534.
Chicago author-date
Wehlou, Charline, Marijn Speeckaert, Tom Fiers, Marc De Buyzere, and Joris Delanghe. 2013. “α₁-Microglobulin/albumin Ratio May Improve Interpretation of Albuminuria in Statin-treated Patients.” Clinical Chemistry and Laboratory Medicine 51 (7): 1529–1534.
Chicago author-date (all authors)
Wehlou, Charline, Marijn Speeckaert, Tom Fiers, Marc De Buyzere, and Joris Delanghe. 2013. “α₁-Microglobulin/albumin Ratio May Improve Interpretation of Albuminuria in Statin-treated Patients.” Clinical Chemistry and Laboratory Medicine 51 (7): 1529–1534.
Vancouver
1.
Wehlou C, Speeckaert M, Fiers T, De Buyzere M, Delanghe J. α₁-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients. CLINICAL CHEMISTRY AND LABORATORY MEDICINE. 2013;51(7):1529–34.
IEEE
[1]
C. Wehlou, M. Speeckaert, T. Fiers, M. De Buyzere, and J. Delanghe, “α₁-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients,” CLINICAL CHEMISTRY AND LABORATORY MEDICINE, vol. 51, no. 7, pp. 1529–1534, 2013.
@article{4422330,
  abstract     = {Background: Statins can cause tubular proteinuria by inhibiting tubular reabsorption of urinary proteins. To distinguish between microalbuminuria originating from glomerular leakage of albumin and tubular microalbuminuria due to statin therapy, the alpha(1)-microglobulin/albumin ratio is evaluated in patients taking statins and compared to untreated patients.
Methods: Ten apparently healthy subjects were given 40 mg of simvastatin and tested for urinary alpha(1)-microglobulin, albumin, creatinine and cystatin C, up to 24 h after administration. Additionally, urine samples of 76 statin-treated and 456 untreated patients presenting with micro-albuminuria (albuminuria range between 20 and 200 mg/L) were tested for alpha(1)-microglobulin and albumin. alpha(1)-Microglobulin/albumin ratios were compared. Total cholesterol was measured in 50 patients on statin therapy.
Results: In the 10 apparently healthy subjects, a significant temporary increase of alpha(1)-microglobulin, albumin and alpha(1)-microglobulin/albumin ratio was observed after statin intake. In the group of 532 patients showing microalbuminuria, those treated with statins showed a significantly higher mean urinary alpha(1)-microglobulin/albumin ratio then untreated patients. Urinary albumin concentrations were significantly higher in patients taking simvastatin than in patients on rosuvastatin treatment and they were also higher in patients on statin therapy with a total serum cholesterol concentration below 3.88 mmol/L than in patients with a total serum cholesterol concentration above 5.17 mmol/L.
Conclusions : Tubular proteinuria, caused by the use of statins, can be distinguished from glomerular proteinuria by a higher urinary alpha(1)-microglobulin/albumin ratio.},
  author       = {Wehlou, Charline and Speeckaert, Marijn and Fiers, Tom and De Buyzere, Marc and Delanghe, Joris},
  issn         = {1434-6621},
  journal      = {CLINICAL CHEMISTRY AND LABORATORY MEDICINE},
  keywords     = {MEGALIN,RECEPTOR-MEDIATED ENDOCYTOSIS,PROTEIN,INHIBITORS,HEMATURIA,PATHWAY,COMPLEX,CUBILIN,GTPASES,URINE,statins,proteinuria,alpha(1)-microglobulin,albumin},
  language     = {eng},
  number       = {7},
  pages        = {1529--1534},
  title        = {α₁-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients},
  url          = {http://dx.doi.org/10.1515/cclm-2012-0798},
  volume       = {51},
  year         = {2013},
}

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