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

Charline M.J. Wehlou; Marijn M. Speeckaert; Tom Fiers; Marc L. De Buyzere; Joris R. Delanghe

doi:10.1515/cclm-2012-0798

Article

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

Charline M.J. Wehlou , Marijn M. Speeckaert , Tom Fiers , Marc L. De Buyzere and Joris R. Delanghe

Published/Copyright: January 11, 2013

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From the journal Clinical Chemistry and Laboratory Medicine Volume 51 Issue 7

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 α₁-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 α₁-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 α₁-microglobulin and albumin. α₁-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 α₁-microglobulin, albumin and α₁-microglobulin/albumin ratio was observed after statin intake. In the group of 532 patients showing micro-albuminuria, those treated with statins showed a significantly higher mean urinary α₁-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 α₁-microglobulin/albumin ratio.

Keywords: albumin; α1-microglobulin; proteinuria; statins

Corresponding author: Joris R. Delanghe, Department of Clinical Chemistry, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium, Phone: +32 9 3322956, Fax: +32 9 3324985

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

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Received: 2012-11-22

Accepted: 2012-12-13

Published Online: 2013-01-11

Published in Print: 2013-07-01

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Articles in the same Issue

https://doi.org/10.1515/cclm-2012-0798

Keywords for this article

albumin; α1-microglobulin; proteinuria; statins