Ann Lab Med.  2017 Jan;37(1):9-17. 10.3343/alm.2017.37.1.9.

Morning Spot Urine Glucose-to-Creatinine Ratios Predict Overnight Urinary Glucose Excretion in Patients With Type 2 Diabetes

• Kim SR
• Lee YH
• Lee SG
• Lee SH
• Kang ES
• Cha BS
• Lee HC
• Kim JH
• Lee BW

• KMID: 2373608
• DOI: http://doi.org/10.3343/alm.2017.37.1.9

Abstract

BACKGROUND
With the advent of sodium glucose co-transporter 2 inhibitors to control glucose and treat diabetes, laboratory data aided by either timed or spot glucose levels in the urine could be used as an alternative marker of drug response. The aim of this study was to assess the agreement between overnight urinary glucose excretion (UGE) and morning spot urinary glucose-to-creatinine ratio (UGCR).
METHODS
In this prospective cross-sectional study, we enrolled a total of 215 participants with either normal glucose tolerance (NGT), pre-diabetes, or type 2 diabetes mellitus (T2DM). To exclude external factors such as food intake and physical activity, urine samples collected overnight at an 8-hr interval and the first-voided morning spot urine were collected and compared.
RESULTS
The median values of overnight 8-hr UGE in participants with NGT (N=14), pre-diabetes (N=41), and T2DM (N=160) were 35.0 mg, 35.6 mg, and 653.4 mg, respectively. In participants with T2DM, the median values of overnight 8-hr UGCR and first-voided morning spot UGCR (M-UGCR) were 1.37 mg/mg and 0.16 mg/mg, respectively. Quantitative analyses using an intraclass correlation coefficient (ICC) demonstrated a good reliability of measurement of the overnight 8-hr UGCR and M-UGCR (ICC=0.943, P<0.001). The M-UGCR was also significantly related to the overnight 8-hr UGE (r=0.828, P<0.001).
CONCLUSIONS
M-UGCR and overnight 8-hr UGCR showed good agreement, suggesting that M-UGCR be used as a simple index for estimating overnight amounts of UGE in patients with T2DM.

Keyword

Type 2 diabetes mellitus; Urinary glucose excretion; Urinary glucose-to-creatinine ratio

MeSH Terms

Adult
Aged
Blood Glucose/analysis
Creatinine/*urine
Cross-Sectional Studies
Diabetes Mellitus, Type 2/*pathology
Female
Glucose/*analysis/metabolism
Humans
Linear Models
Male
Middle Aged
Prospective Studies
Urinalysis
Blood Glucose
Creatinine
Glucose

Figure

• 

  Fig. 1 Overnight 8-hr UGE and UGCR. (A) Distribution of overnight 8-hr UGE values. Outliers of overnight 8-hr UGE above 100,000 mg (N = 2) were excluded in the graph. (B, C) Comparison of the correlation coefficient values between UGCRs and UNCRs.

• 

  Fig. 2 Bland-Altman plot for assessing the agreement between the overnight 8-hr UGCR and M-UGCR.

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