Moore T H, Shield J P
Division of Child Health, University of Bristol, Royal Hospital for Sick Children, United Kingdom.
J Diabetes Complications. 1999 May-Jun;13(3):122-8. doi: 10.1016/s1056-8727(99)00033-1.
Our objective was to assess the feasibility of examining the prevalence of microalbuminuria nationally and to validate the effectiveness of the collection and central analysis of biological specimens. In a centrally coordinated, cross-sectional, multicenter pilot study in pediatric, diabetes outpatients clinics in UK and the Republic of Ireland, blood and urine samples were collected from patients aged between 10 and 20 years, with a duration of insulin-dependent diabetes greater than 1 year attending diabetes outpatient clinics, between April 1996 and February 1997. These samples were analyzed at a central reference laboratory for HbA1C using high performance liquid chromatography (HPLC) and for urinary albumin and creatinine concentrations using spectrophotometry. Clinical data were collected locally and sent to the coordinator for analysis. A total of 419 patients were recruited to the study from ten centers of whom 308 (74%) correctly provided three timed overnight urine samples; 13 patients (4.2%) were microalbuminuric (AER > or =20 microg min(-1) in at least two of three urine samples), 1 (0.3%) was proteinuric (AER > or = 200 microg min(-1) in at least two of three urine samples). All patients found to have microalbuminuria and proteinuria were pubertal or post-pubertal. This study demonstrates that it is possible to coordinate a network of centers in the United Kingdom and the Republic of Ireland for the purposes of diabetes research in young adults and children. The level of abnormal albumin excretion of 4.5% is less than previously described in such age groups in other countries.
我们的目标是评估在全国范围内检测微量白蛋白尿患病率的可行性，并验证生物样本收集及集中分析的有效性。在英国和爱尔兰共和国针对儿科糖尿病门诊患者开展的一项由中央协调的横断面多中心试点研究中，于1996年4月至1997年2月期间，从年龄在10至20岁、胰岛素依赖型糖尿病病程超过1年且前往糖尿病门诊就诊的患者中采集血液和尿液样本。这些样本在中央参考实验室使用高效液相色谱法（HPLC）分析糖化血红蛋白（HbA1C），并使用分光光度法分析尿白蛋白和肌酐浓度。临床数据在当地收集后发送给协调员进行分析。共有419名患者从十个中心招募入本研究，其中308名（74%）正确提供了三份定时过夜尿液样本；13名患者（4.2%）存在微量白蛋白尿（三份尿液样本中至少两份的尿白蛋白排泄率[AER]≥20μg/min），1名患者（0.3%）存在蛋白尿（三份尿液样本中至少两份的AER≥200μg/min）。所有被发现有微量白蛋白尿和蛋白尿的患者均处于青春期或青春期后。本研究表明，为了开展针对青少年和儿童的糖尿病研究，在英国和爱尔兰共和国协调多个中心组成的网络是可行的。4.5%的异常白蛋白排泄水平低于其他国家此前报道的该年龄组水平。
