Torffvit O, Agardh C D, Thulin T
Department of Internal Medicine, University Hospital, Lund, Sweden.
Scand J Urol Nephrol. 1999 Jun;33(3):187-91. doi: 10.1080/003655999750015970.
The study was performed in order to evaluate to what extent hypertension or diabetes mellitus may affect the urinary excretion rate of Tamm-Horsfall protein.
The urinary excretion rates of albumin and Tamm-Horsfall protein, a measure of glomerular and distal tubular function, respectively were measured in patients with essential hypertension (n = 17) and in type 1 diabetes with (n = 20) or without nephropathy (n = 8) and in apparently healthy subjects (n = 10).
Mean 24-h ambulatory blood pressure measurements showed higher blood pressure levels in the hypertensive (167/ 106 mmHg, p < 0.001) than in the diabetic patients with (136/84 mmHg) and without nephropathy (121/74 mmHg) and in healthy subjects (122/76 mmHg). Day and night ratios of systolic and diastolic blood pressure levels were not different among the four groups. Urinary albumin excretion rate was increased in patients with hypertension (30.8 x/ 3.4 microg/min; geometric mean x/tolerance factor; p < 0.001) and diabetes with nephropathy (462 x/ 3.5 microg/min; p < 0.001) compared with diabetic patients without nephropathy and healthy subjects (4.6 x/ 1.9 and 3.7 x/ 1.5 microg/min, respectively). The Tamm-Horsfall protein excretion rate was decreased in patients with diabetic nephropathy (11.6 x/ 3.5 microg/min) compared to patients with hypertension (36.3 x/2.1 1g/min; p < 0.01), diabetes without nephropathy (39.2 x/ 2.0 microg/min; p < 0.05) and healthy subjects (63.0 x/ 1.4 microg/min; p < 0.001), whereas no differences were found among the latter three groups.
These data indicate that high blood pressure may be associated with albuminuria, while a decrease in excretion rate of Tamm-Horsfall protein may be associated with diabetic nephropathy. These associations need to be studied in a larger population.
开展本研究以评估高血压或糖尿病在多大程度上可能影响Tamm-Horsfall蛋白的尿排泄率。
分别测定了原发性高血压患者（n = 17）、1型糖尿病伴肾病患者（n = 20）、1型糖尿病不伴肾病患者（n = 8）以及健康受试者（n = 10）的白蛋白和Tamm-Horsfall蛋白的尿排泄率，白蛋白和Tamm-Horsfall蛋白的尿排泄率分别是肾小球和远端肾小管功能的一项指标。
24小时动态血压均值显示，高血压患者（167/106 mmHg，p < 0.001）的血压水平高于伴肾病的糖尿病患者（136/84 mmHg）、不伴肾病的糖尿病患者（121/74 mmHg）以及健康受试者（122/76 mmHg）。四组间收缩压和舒张压水平的昼夜比值无差异。与不伴肾病的糖尿病患者和健康受试者（分别为4.6 x/1.9和3.7 x/1.5微克/分钟）相比，高血压患者（30.8 x/3.4微克/分钟；几何均值x/耐受因子；p < 0.001）以及伴肾病的糖尿病患者（462 x/3.5微克/分钟；p < 0.001）的尿白蛋白排泄率升高。与高血压患者（36.3 x/2.1微克/分钟；p < 0.01）、不伴肾病的糖尿病患者（39.2 x/2.0微克/分钟；p < 0.05）以及健康受试者（63.0 x/1.4微克/分钟；p < 0.001）相比，伴糖尿病肾病患者的Tamm-Horsfall蛋白排泄率降低，而后三组之间未发现差异。
这些数据表明，高血压可能与蛋白尿有关，而Tamm-Horsfall蛋白排泄率降低可能与糖尿病肾病有关。这些关联需要在更大规模人群中进行研究。
