Umeda F, Tajiri Y, Nawata H
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Endocrinol Jpn. 1989 Oct;36(5):747-54. doi: 10.1507/endocrj1954.36.747.
The albumin index (mg/g . creatinine) was determined in untimed spot urine collected in the early morning from 92 randomly selected outpatients with noninsulin-dependent diabetes mellitus (NIDDM). The patients were divided into three groups: 49 patients with normo-albuminuria (albumin index less than 9.1), 24 with micro-albuminuria (albumin index between 9.1 and 100), and 19 with overt-albuminuria (albumin index over than 100). With diabetic duration, the frequency of the patients with overt-albuminuria was increased, but that with normo-albuminuria was decreased. The patients treated with only a diet almost showed normo-albuminuria. In contrast, micro-and overt-albuminuria were found more frequently in the patients treated with oral hypoglycemic agents or insulin. Micro- and overt-albuminuria were found more frequently in the patients with poor glycemic control than in those with good glycemic control. The urinary albumin index was significantly high in the micro-albuminuric patients with poor glycemic control. Similarly, micro- and overt-albuminuria were found more frequently in the patients associated with diabetic retinopathy or neuropathy than in those without diabetic complications. In addition, overt-albuminuria was found more frequently in the patients with hypertension. The urinary albumin index was significantly high in the overt-albuminuric patients with hypertension. In conclusion, the determination of the albumin index in spot urine may be outpatients with NIDDM.
对92例随机选取的非胰岛素依赖型糖尿病（NIDDM）门诊患者清晨采集的随机尿样测定白蛋白指数（mg/g·肌酐）。患者分为三组：49例正常白蛋白尿患者（白蛋白指数小于9.1），24例微量白蛋白尿患者（白蛋白指数在9.1至100之间），19例显性白蛋白尿患者（白蛋白指数大于100）。随着糖尿病病程延长，显性白蛋白尿患者的比例增加，而正常白蛋白尿患者的比例下降。仅接受饮食治疗的患者几乎均表现为正常白蛋白尿。相比之下，口服降糖药或胰岛素治疗的患者中，微量白蛋白尿和显性白蛋白尿更为常见。血糖控制差的患者比血糖控制良好的患者更易出现微量白蛋白尿和显性白蛋白尿。血糖控制差的微量白蛋白尿患者尿白蛋白指数显著升高。同样，合并糖尿病视网膜病变或神经病变的患者比无糖尿病并发症的患者更易出现微量白蛋白尿和显性白蛋白尿。此外，高血压患者中显性白蛋白尿更为常见。高血压显性白蛋白尿患者的尿白蛋白指数显著升高。总之，测定随机尿样中的白蛋白指数可能对NIDDM门诊患者有帮助。
