Gibb D M, Dunger D, Levin M, Shah V, Smith C, Barratt T M
Department of Paediatric Nephrology, Institute of Child Health, London.
Arch Dis Child. 1989 Jul;64(7):984-91. doi: 10.1136/adc.64.7.984.
We investigated the associations between albuminuria, metabolic control, glomerular filtration, blood pressure, and platelet function in children with insulin dependent diabetes mellitus. The geometric mean (95% tolerance levels) albumin excretion (expressed as the geometric mean albumin to creatinine ratio on two overnight urine collections (UA/UC], in 60 diabetic children was 0.72 (0.80-6.9) mg/mmol, significantly greater than in 45 normal children (geometric mean 0.41 (0.14-1.17]. Mean (SD) glomerular filtration rate, measured by 51Cr edetic acid clearance during constant infusion, was significantly greater in diabetic children (129 (20) ml/min/1.73 m2) compared with normal controls (109 (13]. Mean (SD) renal length for height standard deviation score was +0.25 (1.1); systolic blood pressure standard deviation score was 0.15 (0.65), and diastolic blood pressure was 0.51 (0.82). Spontaneous platelet aggregation, expressed as percentage fall in platelet count in stirred whole blood after 2 minutes was 17.8 (9.2)% in the diabetic compared with 12.3 (7.9)% in normal children. UA/UC correlated with renal length and of the children with UA/UC above the normal range, 70% also had a glomerular filtration rate above the normal range. There was a weak correlation between UA/UC and glycated haemoglobin (HbA1c). All children with spontaneous platelet aggregation above normal had had diabetes for more than seven years. These cross sectional data define some of the early markers and inter-relationships that may be important in the development of nephropathy.
我们研究了胰岛素依赖型糖尿病儿童蛋白尿、代谢控制、肾小球滤过、血压和血小板功能之间的关联。60名糖尿病儿童的尿白蛋白排泄几何均值（95%耐受水平，以两次过夜尿液收集的尿白蛋白与肌酐比值的几何均值表示[UA/UC]）为0.72（0.80 - 6.9）mg/mmol，显著高于45名正常儿童（几何均值0.41（0.14 - 1.17））。通过持续输注期间的51Cr依地酸清除率测量的平均（标准差）肾小球滤过率，糖尿病儿童（129（20）ml/min/1.73 m2）显著高于正常对照组（109（13））。身高标准差评分的平均（标准差）肾长度为 +0.25（1.1）；收缩压标准差评分为0.15（0.65），舒张压为0.51（0.82）。以搅拌全血2分钟后血小板计数下降百分比表示的自发血小板聚集，糖尿病儿童为17.8（9.2）%，正常儿童为12.3（7.9）%。UA/UC与肾长度相关，在UA/UC高于正常范围的儿童中，70%的肾小球滤过率也高于正常范围。UA/UC与糖化血红蛋白（HbA1c）之间存在弱相关性。所有自发血小板聚集高于正常的儿童患糖尿病均超过七年。这些横断面数据确定了一些可能在肾病发展中起重要作用的早期标志物和相互关系。
