Front Med (Lausanne). 2026 Sep 16;13:1816283. doi: 10.3389/fmed.2026.1816283. eCollection 2026.
ABSTRACT
INTRODUCTION: Urinary N-acetyl-β-D-glucosaminidase (uNAG), a sensitive biomarker of renal tubular injury, has been linked to vascular pathology through oxidative stress, inflammation, and endothelial dysfunction. However, sex-specific associations between uNAG and early vascular damage remain unclear.
METHODS: This cross-sectional study included 2,621 adults undergoing routine health examinations. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV), with increased arterial stiffness defined as a mean baPWV >1,700 cm/s. uNAG and baPWV were measured using standardized protocols. Sex-stratified logistic regression analyses were performed.
RESULTS: In men, participants in the highest uNAG tertile had more than twofold higher adjusted odds of increased arterial stiffness after adjustment for age, mean arterial pressure, antihypertensive medication use, fasting glucose, triglycerides, and LDL-C (OR, 2.372; 95% CI, 1.603-3.510; P = 1.55 × 10-5). In women, the highest tertile was not significantly associated with increased arterial stiffness (OR, 0.842; 95% CI, 0.528-1.342; P = 0.470). Women in the intermediate tertile had lower adjusted odds (OR, 0.570; 95% CI, 0.343-0.947; P = 0.030), although this finding warrants caution because female uNAG values substantially clustered at 5.00 IU/L. The sex-by-uNAG tertile interaction was significant (P for interaction = 0.003).
DISCUSSION: Elevated uNAG was more strongly associated with increased arterial stiffness in men than in women, suggesting sex-related effect modification. Because of the cross-sectional design, these findings indicate associations rather than causal relationships.
PMID:42819162 | PMC:PMC13623695 | DOI:10.3389/fmed.2026.1816283