Szigeti N, Markó L, Molnár G A, Fábián G, Cseh J, Mohás M, Figler M, Király A, Kõszegi T, Wittmann I
2nd Department of Medicine and Nephrological Center, University of Pécs, Faculty of Medicine, Pécs, Hungary.
Acta Gastroenterol Belg. 2009 Oct-Dec;72(4):394-401.
To measure urinary albumin excretion using immunoturbidimetry (IT) and high-performance liquid chromatography (HPLC) in inflammatory bowel diseases.
A cross-sectional study was carried out on 60 selected patients with Crohn's disease (CD), 57 with ulcerative colitis (UC) and 22 healthy volunteers, as controls. Urinary albumin excretion was measured by IT and HPLC, and albumin-creatinine ratio was calculated. This ratio was compared in patients with active and inactive CD and UC and in healthy volunteers.
Patients with CD and UC had higher albumin-creatinine ratio compared to controls using both IT and HPLC (p < 0.05). We measured higher albumin-creatinine ratio in patients with active compared to inactive CD (p < 0.05). Albuminuria did not correlate with disease duration of CD or UC, but patients with more extended CD according to the Montreal classification had higher HPLC-albumin-creatinine ratio. In CD, we found a significant correlation between HPLC-albumin-creatinine ratio and some inflammatory markers i.e. white blood cells (p < 0.05) and erythrocyte sedimentation rate (p < 0.05). In UC, there was no significant correlation between HPLC-albumin-creatinine ratio and the above markers of systemic inflammation or activity of UC. Albumin-creatinine ratio measured by HPLC was higher in both active and inactive CD and UC groups than albumin-creatinine ratio measured by IT. Using a receiver operating characteristics curve analysis, in case of HPLC-albumin-creatinine ratio cut-off values of the activity of CD were 2.46 mg/mmol for men, 5.30 mg/mmol for women.
HPLC-urinary albumin-creatinine ratio is associated with the clinical and laboratory disease activity indices in CD, but not in UC. Using HPLC we found a more sensitive method compared to IT to measure albuminuria that would be a sensitive activity marker in CD.
采用免疫比浊法（IT）和高效液相色谱法（HPLC）测定炎症性肠病患者的尿白蛋白排泄量。
选取60例克罗恩病（CD）患者、57例溃疡性结肠炎（UC）患者及22名健康志愿者作为对照，进行横断面研究。采用IT和HPLC测定尿白蛋白排泄量，并计算白蛋白-肌酐比值。对活动期和非活动期CD及UC患者与健康志愿者的该比值进行比较。
无论是采用IT还是HPLC，CD和UC患者的白蛋白-肌酐比值均高于对照组（p < 0.05）。与非活动期CD患者相比，活动期CD患者的白蛋白-肌酐比值更高（p < 0.05）。蛋白尿与CD或UC的病程无关，但根据蒙特利尔分类法，病变范围更广的CD患者的HPLC-白蛋白-肌酐比值更高。在CD患者中，我们发现HPLC-白蛋白-肌酐比值与一些炎症指标即白细胞（p < 0.05）和红细胞沉降率（p < 0.05）之间存在显著相关性。在UC患者中，HPLC-白蛋白-肌酐比值与上述全身炎症指标或UC活动度之间无显著相关性。活动期和非活动期CD及UC组中，HPLC测定的白蛋白-肌酐比值均高于IT测定的白蛋白-肌酐比值。采用受试者工作特征曲线分析，对于HPLC-白蛋白-肌酐比值，男性CD活动度的截断值为2.46 mg/mmol，女性为5.30 mg/mmol。
HPLC-尿白蛋白-肌酐比值与CD的临床及实验室疾病活动指标相关，而与UC无关。与IT相比，采用HPLC发现了一种更敏感的测定蛋白尿的方法，该方法可作为CD的敏感活动标志物。
