Singh S K, Behre A, Singh M K
Department of Endocrinology and Ophthalmology, Banaras Hindu University, Varanasi.
J Assoc Physicians India. 2001 Apr;49:439-41.
Relationship between microalbuminuria and diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus has been described. Patients with lean type 2 diabetes mellitus has some difference of insulin secretion and action in comparison with obese type 2 diabetes mellitus and there are evidences to support that lean type 2 diabetes mellitus is slow emerging type 1 diabetes mellitus in our population. The aim of this study is to find out correlation between retinopathy and microalbuminuria in lean type 2 diabetes mellitus.
Fifty two patients with lean type 2 diabetes mellitus (BMI < 18.5 Kg/M2) were selected. Diabetic retinopathy was observed in 25 patients only. Blood glucose sample was taken after 10 hours of overnight fasting. Glycosylated haemoglobin (HbA1c) was measured by calorimetric method and urinary albumin was estimated in morning urine saniple by Micral II test strip.
Patients with diabetic retinopathy had longer duration of diabetes detected than those with normal fundus but the difference was statistically insignificant. Fasting blood glucose greater than 200 mg/dl was found in 63.6% of patients with diabetic retinopathy and in 36.4% of patients with normal fundus but the difference was insiginificant. Patients with diabetic retinopathy had microalbuminuria test positive and level was significantly higher in patients with proliferative retinopathy than in patients with background retinopathy.
Microalbuminuria is associated with diabetic retinopathy in lean type 2 diabetes mellitus. Increase in urinary albumin excretion correlates with development of proliferative diabetic retinopathy in lean type 2 diabetes mellitus similar to type 1 and type 2 diabetes niellitus. This study emphasizes that microalbuminuria estimated by semi quantitative method is a cost effective and reliable marker of diabetic retinopathy in lean type 2 diabetes mellitus and high level of this may serve as an indicator of proliferative retinopathy in them.
1型和2型糖尿病患者中微量白蛋白尿与糖尿病视网膜病变之间的关系已有描述。与肥胖型2型糖尿病患者相比，消瘦型2型糖尿病患者在胰岛素分泌和作用方面存在一些差异，并且有证据支持在我们的人群中，消瘦型2型糖尿病是缓慢出现的1型糖尿病。本研究的目的是找出消瘦型2型糖尿病患者视网膜病变与微量白蛋白尿之间的相关性。
选取52例消瘦型2型糖尿病患者（体重指数<18.5 Kg/M2）。仅25例患者观察到糖尿病视网膜病变。过夜禁食10小时后采集血糖样本。采用比色法测定糖化血红蛋白（HbA1c），并通过Micral II试纸条对晨尿样本中的尿白蛋白进行评估。
糖尿病视网膜病变患者的糖尿病病程长于眼底正常患者，但差异无统计学意义。63.6%的糖尿病视网膜病变患者空腹血糖大于200 mg/dl，而眼底正常患者中这一比例为36.4%，但差异不显著。糖尿病视网膜病变患者微量白蛋白尿检测呈阳性，增殖性视网膜病变患者的水平显著高于背景性视网膜病变患者。
消瘦型2型糖尿病患者中微量白蛋白尿与糖尿病视网膜病变相关。尿白蛋白排泄增加与消瘦型2型糖尿病增殖性糖尿病视网膜病变的发展相关，这与1型和2型糖尿病相似。本研究强调，通过半定量方法估算的微量白蛋白尿是消瘦型2型糖尿病患者糖尿病视网膜病变的一种经济有效且可靠的标志物，其高水平可能是他们增殖性视网膜病变的一个指标。
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