Hofmann W, Guder W G
Institut für Klinische Chemie, Städtisches Krankenhaus Bogenhausen, München.
Klin Wochenschr. 1989;67 Suppl 17:37-9.
In the second morning urine of 51 patients with diabetes mellitus (type I/II) albumin, N-acetyl-beta-D-glucosaminidase (NAG), alpha 1-microglobulin (alpha 1-M/U), creatinine (reference parameter) as well as serum alpha 1-microglobulin and creatine were determined. Following an international expert recommendation, three groups were formed depending on albumin excretion: group 1: albumin less than 24 mg/g creatinine (normal range) group 2: albumin greater than 24 mg/g creatinine and less than 200 mg/g creatinine (so called microalbuminuria) group 3: albumin greater than 200 mg/g creatinine (manifest proteinuria) The urinary tubular parameters NAG and alpha 1-microglobulin were above normal range in 17 and 21% respectively in group 1. For group 2 the results were abnormal in 94 and 69% and for group 3 in 100% of patients. Albuminuria correlated with NAG activity, but not with alpha 1-microglobulin excretion. These results indicate, that measuring NAG and alpha 1-microglobulin as markers for tubular dysfunction can give additional diagnostic informations about type and degree of diabetic nephropathy.
对51例I型/II型糖尿病患者的晨尿进行检测,测定其中白蛋白、N - 乙酰 - β - D - 氨基葡萄糖苷酶(NAG)、α1 - 微球蛋白(α1 - M/U)、肌酐(参考参数)以及血清α1 - 微球蛋白和肌酸。根据国际专家建议,依据白蛋白排泄量分为三组:第1组:白蛋白低于24mg/g肌酐(正常范围);第2组:白蛋白高于24mg/g肌酐且低于200mg/g肌酐(所谓的微量白蛋白尿);第3组:白蛋白高于200mg/g肌酐(显性蛋白尿)。在第1组中,肾小管参数NAG和α1 - 微球蛋白分别有17%和21%高于正常范围。在第2组中,94%和69%的患者结果异常,在第3组中,100%的患者结果异常。蛋白尿与NAG活性相关,但与α1 - 微球蛋白排泄无关。这些结果表明,将NAG和α1 - 微球蛋白作为肾小管功能障碍的标志物进行检测,可以为糖尿病肾病的类型和程度提供额外的诊断信息。