Kumar Anoop, Kapoor Sangeeta, Gupta R C
MSc. Medical Biochemistry, Demonstrator, Department of Biochemistry, Rama Medical College , Ghaziabad (U.P.), India .
J Clin Diagn Res. 2013 Apr;7(4):622-6. doi: 10.7860/JCDR/2013/4745.2867. Epub 2013 Apr 1.
Proteinuria has been recognized as one of the earliest signs of renal function deterioration in Diabetes mellitus. Proteinuria occurs due to alterations in the glomerular permeability and later, due to a failure in the reabsorption of filtered protein by the tubular cells. Normally, most of the healthy adults excrete 20-150 mg of protein in urine over 24 hours.
To find out the normal urinary Protein Creatinine Index (PCI) in healthy subjects, to compare the urinary PCI of diabetic patients with that of healthy subjects and to compare the urinary PCI with dipsticks for the detection of microproteinuria.
This study was conducted on 28 type 2 Diabetes mellitus patients and 40 age and sex matched healthy controls. Freshly collected urine samples were tested qualitatively for the presence of proteinuria by Heller's test, the sulfosalicylic acid test, heat-coagulation tests and urine dipsticks. Later on, the results were compared by performing a quantitative analysis of the protein in the spot urine samples by the sulfosalicylic acid method. A quantitative analysis of creatinine was done by the modified Jaffe's test. The PCI was calculated for each of the participant in the study. The Mean and Standard Deviation (SD) of the PCI was calculated and it was compared between the two groups.
The normal range of the PCI which was established in this study was 60 to 220. Significantly higher amount of proteins were found to be excreted in urine in diabetic patients (25.37 ± 12.51 mg/dl) as compared to those in normal subjects (8.93 ± 3.54 mg/dl). On comparison of the PCI between the controls and the diabetic subjects, it was found to be significantly elevated in the Diabetes mellitus patients (controls = 114.65 ±47.97 and in the diabetic patients =373.04 ± 98.53) (p < 0.001).
The PCI of a random urine sample can provide a very useful, simple and convenient method for the quantitative assessment of proteinuria, to judge the extent of kidney damage and for avoiding the drawbacks of the 24 - hr urine collections.
蛋白尿已被认为是糖尿病患者肾功能恶化的最早迹象之一。蛋白尿的发生是由于肾小球通透性改变，随后是由于肾小管细胞对滤过蛋白的重吸收功能障碍。正常情况下，大多数健康成年人24小时尿蛋白排泄量为20 - 150毫克。
了解健康受试者的正常尿蛋白肌酐指数（PCI），比较糖尿病患者与健康受试者的尿PCI，并比较尿PCI与尿试纸检测微量蛋白尿的情况。
本研究对28例2型糖尿病患者和40例年龄、性别匹配的健康对照者进行。采用热凝法、磺基水杨酸法、海勒氏试验及尿试纸对新鲜采集的尿液样本进行蛋白尿定性检测。随后，采用磺基水杨酸法对随机尿样中的蛋白质进行定量分析，并比较结果。采用改良的杰氏试验对肌酐进行定量分析。计算本研究中每位参与者的PCI。计算PCI的均值和标准差，并在两组之间进行比较。
本研究确定的PCI正常范围为60至220。与正常受试者（8.93±3.54毫克/分升）相比，糖尿病患者尿中排出的蛋白量显著更高（25.37±12.51毫克/分升）。比较对照组和糖尿病患者的PCI，发现糖尿病患者的PCI显著升高（对照组=114.65±47.97，糖尿病患者=373.04±98.53）（p<0.001）。
随机尿样的PCI可为蛋白尿的定量评估、判断肾脏损伤程度以及避免24小时尿收集的缺点提供一种非常有用、简单且方便的方法。
