Walker J D, Tariq T, Viberti G
Unit for Metabolic Medicine, United Medical School, Guy's Hospital, London.
BMJ. 1990 Sep 29;301(6753):635-8. doi: 10.1136/bmj.301.6753.635.
To determine whether there are familial and genetic aspects of sodium-lithium countertransport activity in red cells in diabetic nephropathy.
Case-control study.
Teaching hospital diabetic clinic.
40 Patients with insulin dependent diabetes, both of whose parents were alive: 20 with persistent proteinuria and 20 with normal albumin excretion matched for age, duration of diabetes, and body mass index. All 80 parents.
Sodium-lithium countertransport activity in red cells and arterial blood pressure.
Sodium-lithium countertransport activity in red cells was higher in the patients with proteinuria than in the patients with normoalbuminuria (mean (95% confidence interval) 0.47 (0.39 to 0.54) v 0.33 (0.28 to 0.38) mmol/l red cells/h respectively, p = 0.0036; mean difference 0.14 (0.04 to 0.22)). The mean countertransport activity for the two parents of each patient was calculated, and from this the mean value for each group of parents was calculated; the value was higher in the parents of the patients with proteinuria than in the parents of the patients with normoalbuminuria (0.40 (0.32 to 0.48) v 0.30 (0.26 to 0.33) mmol/l red cells/h respectively, p = 0.016; 0.10 (0.02 to 0.19)). Twenty-eight of the parents of the patients with proteinuria compared with 12 of the parents of the patients with normoalbuminuria had a countertransport activity that was above the median value in all 80 parents (p less than 0.001). Mean arterial blood pressure in the parents of the patients with proteinuria was related to that of their offspring (r = 0.46; p less than 0.01). There was a positive correlation between the sodium-lithium countertransport activity in red cells in the parents and their offspring when all parents and patients were considered (r = 0.37; p less than 0.001).
Increased sodium-lithium countertransport activity in red cells in the parents of diabetic patients with nephropathy provides further evidence that familial, and possibly genetic, factors related to a predisposition to arterial hypertension have a role in the susceptibility of diabetic renal disease.
确定糖尿病肾病患者红细胞钠-锂逆向转运活性是否存在家族性和遗传方面的因素。
病例对照研究。
教学医院糖尿病诊所。
40例胰岛素依赖型糖尿病患者，其父母均在世：20例持续性蛋白尿患者和20例白蛋白排泄正常患者，年龄、糖尿病病程和体重指数相匹配。所有80名父母。
红细胞钠-锂逆向转运活性和动脉血压。
蛋白尿患者红细胞钠-锂逆向转运活性高于正常白蛋白尿患者（分别为均值（95%可信区间）0.47（0.39至0.54）与0.33（0.28至0.38）mmol/升红细胞/小时，p = 0.0036；均值差异0.14（0.04至0.22））。计算每位患者的两位父母的平均逆向转运活性，并据此计算每组父母的平均值；蛋白尿患者父母的值高于正常白蛋白尿患者父母的值（分别为0.40（0.32至0.48）与0.30（0.26至0.33）mmol/升红细胞/小时，p = 0.016；0.10（0.02至0.19））。蛋白尿患者的28位父母与正常白蛋白尿患者的12位父母相比，其逆向转运活性高于所有80位父母的中位数（p < 0.001）。蛋白尿患者父母的平均动脉血压与其后代的平均动脉血压相关（r = 0.46；p < 0.01）。当考虑所有父母和患者时，父母红细胞钠-锂逆向转运活性与其后代之间存在正相关（r = 0.37；p < 0.001）。
糖尿病肾病患者父母红细胞钠-锂逆向转运活性增加进一步证明，与动脉高血压易感性相关的家族性及可能的遗传因素在糖尿病肾病易感性中起作用。
