Lev-Ran A, Hwang D L, Miller J D, Josefsberg Z
Department of Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA 91010.
Clin Chim Acta. 1990 Dec 3;192(3):201-6. doi: 10.1016/0009-8981(90)90222-e.
Excretion of epidermal growth factor (EGF) is decreased in renal failure. We assayed it in diabetes mellitus in an attempt to relate it to clinical parameters, esp. those of diabetic nephropathy. EGF excretion declined with age but in all age groups of diabetic patients was below the first percentile for controls. In 26 control and 34 prepubertal diabetic children excretion was correspondingly 1126 +/- 442 and 932 +/- 489 pmol/mmol creatinine (P = 0.087); in 26 control and 42 diabetic adolescents below age 18, 778 +/- 222 and 676 +/- 335 (P = 0.023) and in 81 control and 83 diabetic adults, 371 +/- 153 and 235 +/- 140 (P less than 0.0001). Decreased excretion of EGF was seen in some patients without any diabetic complications. Excretion of EGF was independently and inversely correlated with age and duration of diabetes but not with type of diabetes, treatment, body built, C-peptide, plasma glucose, glycohemoglobin or retinopathy. A positive correlation was seen with creatinine clearance and a negative correlation, with albuminuria, but the strongest and the only independent correlation found by stepwise multiple variable selection was with serum creatinine (r -0.711, P less than 0.0001). EGF excretion was not elevated in patients with hyperfiltration. We conclude that EGF excretion is abnormal in many patients with diabetes and that this abnormality reflects a kidney function different from glomerular filtration or glomerular permeability.
肾功能衰竭时表皮生长因子(EGF)的排泄减少。我们对糖尿病患者的EGF进行检测,试图将其与临床参数,尤其是糖尿病肾病的参数联系起来。EGF排泄量随年龄下降,但糖尿病患者各年龄组均低于对照组的第1百分位数。26名对照儿童和34名青春期前糖尿病儿童的EGF排泄量分别为1126±442和932±489 pmol/mmol肌酐(P = 0.087);26名对照青少年和42名18岁以下糖尿病青少年分别为778±222和676±335(P = 0.023);81名对照成人和83名糖尿病成人分别为371±153和235±140(P<0.0001)。一些无任何糖尿病并发症的患者也出现EGF排泄减少。EGF排泄与年龄和糖尿病病程呈独立负相关,但与糖尿病类型、治疗、体型、C肽、血糖、糖化血红蛋白或视网膜病变无关。与肌酐清除率呈正相关,与蛋白尿呈负相关,但逐步多元变量选择发现的最强且唯一的独立相关性是与血清肌酐相关(r = -0.711,P<0.00