Raskin P, Marks J F, Burns H, Plumer M E, Siperstein M D
Am J Med. 1975 Mar;58(3):365-72. doi: 10.1016/0002-9343(75)90602-6.
The effect of juvenile onset diabetes mellitus on quadriceps muscle capillary basement membrane (QCBM) width has been examined by the electron microscopic morphometric method previously developed in this laboratory. The results demonstrate that in this age group QCBM thickening is strongly related to the age of the diabetic subject. As a result, in contrast to the almost constant thickening of QCBM that has consistently been documented in diabetic adults, QCBM hypertrophy is present in only 40 per cent of children with diabetes mellitus. As was previously shown to be the case in adults, in children, too, QCBM thickening is unrelated to the duration of the diabetes. Finally, the finding that QCBM hypertrophy is present at the time of acute onset of juvenile diabetes mellitus in 30 per cent of children, coupled with the fact that this lesion is not affected by duration of hyperglycemia, strongly supports our previous conclusion that diabetic microangiopathy is independent of the hyperglycemia of this disease. On the other hand, barring the possibility that microangiopathy in the pancreas precedes that in muscle, these results represent evidence against the suggestion that basement membrane hypertrophy represents the primary lesion of the diabetic syndrome.
本实验室先前采用电子显微镜形态计量学方法,研究了青少年型糖尿病对股四头肌毛细血管基底膜(QCBM)宽度的影响。结果表明,在该年龄组中,QCBM增厚与糖尿病患者的年龄密切相关。因此,与糖尿病成年人中QCBM几乎持续增厚的情况不同,只有40%的糖尿病儿童存在QCBM肥大。正如先前在成年人中所显示的那样,在儿童中,QCBM增厚也与糖尿病病程无关。最后,30%的儿童在青少年糖尿病急性发作时出现QCBM肥大,以及该病变不受高血糖持续时间影响这一事实,有力地支持了我们先前的结论,即糖尿病微血管病变独立于该疾病的高血糖状态。另一方面,除非胰腺微血管病变先于肌肉微血管病变发生,否则这些结果表明,基底膜肥大是糖尿病综合征原发性病变这一观点是错误的。