Chiarelli F, Pomilio M, De Luca F A, Vecchiet J, Verrotti A
Department of Medicine, University of Chieti, Italy.
Pediatr Nephrol. 2001 Feb;16(2):116-20. doi: 10.1007/s004670000514.
Diabetic microangiopathy is characterized by increased prorenin concentrations. In the present study, we evaluated plasma prorenin concentrations in a large group of adolescents with onset of diabetes during childhood to determine whether increasing prorenin levels may predict the development of persistent microalbuminuria. Ninety-seven young diabetic patients were studied; they were divided according to the presence of persistent microalbuminuria, at the end of follow-up, into group A and group B (patients who did not develop and who developed persistent microalbuminuria, respectively). One hundred and two healthy subjects, matched for age and sex, were also selected. Patients were followed up for at least 10 years. At the beginning of the study there were no significant differences in prorenin levels between either the two diabetic groups or the healthy controls. During follow-up, an increase in plasma prorenin started at 4 years and became statistically significant (P<0.01) 3 years before the onset of persistent microalbuminuria. No correlation was found between plasma prorenin levels and HbAlc percentages. In conclusion, an increased concentration of prorenin in plasma precedes the elevation of albumin excretion rate (AER) and, therefore, can be useful for identifying patients with onset of diabetes during childhood at risk of developing incipient nephropathy later in life.
糖尿病微血管病变的特征是前肾素浓度升高。在本研究中，我们评估了一大群童年期发病的青少年糖尿病患者的血浆前肾素浓度，以确定前肾素水平升高是否可预测持续性微量白蛋白尿的发生。对97名年轻糖尿病患者进行了研究；根据随访结束时是否存在持续性微量白蛋白尿，将他们分为A组和B组（分别为未发生和发生持续性微量白蛋白尿的患者）。还选取了102名年龄和性别匹配的健康受试者。患者随访至少10年。研究开始时，两个糖尿病组与健康对照组之间的前肾素水平均无显著差异。随访期间，血浆前肾素水平在4年时开始升高，并在持续性微量白蛋白尿发作前3年变得具有统计学意义（P<0.01）。未发现血浆前肾素水平与糖化血红蛋白（HbAlc）百分比之间存在相关性。总之，血浆前肾素浓度升高先于白蛋白排泄率（AER）升高，因此，可用于识别童年期发病的糖尿病患者中，日后有发生早期肾病风险的患者。
