Departamento de Ciencias Médicas División de Ciencias de la Salud, Universidad de Guanajuato, León, México.
Diabet Med. 2012 Jan;29(1):70-3. doi: 10.1111/j.1464-5491.2011.03380.x.
Exercise may be useful to detect patients with diabetes prone to develop persistent microalbuminuria. We studied the relationship between exercise intensity, measured as maximal oxygen consumption (VO(2)max), and microalbuminuria in patients with Type 1 diabetes mellitus patients.
We studied 10 patients, age range 10-18 years, with Type 1 diabetes who were normotensive and normoalbuminuric, with less than 10 years since diagnosis. Patients had normal renal function, without infections or clinical evidence of complications. Metabolic control was intensively adjusted in all patients. They underwent three consecutive physical exercise tests, reaching 100, 80 and 60% of the maximal cardiac frequency response.
Eight patients had adequate to regular metabolic control. All patients had lower than predicted VO(2)max values. At 60%, only three patients showed microalbuminuria in excess of 20 μg/min, two of them had inadequate metabolic control. Post-exercise microalbuminuria exceeded normal values in nine, seven and three patients when submitted to 100, 80 and 60% of exercise intensity, respectively.
Microalbuminuria increased with exercise intensity. Sex, body composition and VO(2)max were the main factors associated with microalbuminuria. The prognostic significance of albuminuria induced by intense exercise in these subjects with Type 1 diabetes is not yet known.
运动可能有助于发现易发生持续微量白蛋白尿的糖尿病患者。我们研究了运动强度(以最大摄氧量(VO₂max)表示)与 1 型糖尿病患者微量白蛋白尿之间的关系。
我们研究了 10 名年龄在 10-18 岁之间的 1 型糖尿病患者,这些患者血压正常且尿白蛋白正常,确诊时间不到 10 年。患者的肾功能正常,无感染或并发症的临床证据。所有患者的代谢控制均进行了强化调整。他们进行了连续 3 次体力运动测试,达到最大心率反应的 100%、80%和 60%。
8 名患者的代谢控制适当且规律。所有患者的 VO₂max 值均低于预测值。在 60%时,只有 3 名患者的微量白蛋白尿超过 20μg/min,其中 2 名患者的代谢控制不佳。当进行 100%、80%和 60%的运动强度时,9 名、7 名和 3 名患者的运动后微量白蛋白尿分别超过正常值。
微量白蛋白尿随运动强度增加而增加。性别、身体成分和 VO₂max 是与微量白蛋白尿相关的主要因素。在这些 1 型糖尿病患者中,剧烈运动引起的蛋白尿的预后意义尚不清楚。