Signorini A M, Fondelli C, Tanganelli I, Pallassini A, Gragnoli G
Boll Soc Ital Biol Sper. 1989 Aug;65(8):719-25.
With the aim of evaluating the reliability of morning urine collection, compared to the overnight period, in the assessment of microalbuminuria, we measured albumin and creatinine concentration in overnight and morning urine of 125 diabetic outpatients. The overnight albumin excretion rate resulted in relation to morning albumin concentration and morning albumin/creatinine ratio. The sensitivity of this method of urine collection, compared to the overnight sample, was 55.5%, the specificity 96.6% and the predictive value 43% using, as a measure, the albumin concentration. These values improved by correcting albumin for creatinine concentration. Concerning high risk albuminuria (overnight excretion rate greater than 30 micrograms/min), we found a sensitivity and predictive value of the first morning collection highly improved by the albumin/creatinine ratio. It is concluded that the first morning urine collection can be used in the diagnosis of microalbuminuria in diabetic patients, especially when we calculate the albumin/creatinine ratio. This simple and reliable method allows the identification of microalbuminuric subjects and of the patients at risk to develop clinical nephropathy with a good sensitivity.
为了评估晨尿采集与过夜尿相比在微量白蛋白尿评估中的可靠性，我们测量了125名糖尿病门诊患者过夜尿和晨尿中的白蛋白及肌酐浓度。过夜白蛋白排泄率与晨尿白蛋白浓度及晨尿白蛋白/肌酐比值相关。与过夜样本相比，这种尿液采集方法以白蛋白浓度为指标时，敏感性为55.5%，特异性为96.6%，预测值为43%。通过用肌酐浓度校正白蛋白，这些值有所改善。关于高危白蛋白尿（过夜排泄率大于30微克/分钟），我们发现晨尿首次采集时，白蛋白/肌酐比值能显著提高敏感性和预测值。结论是，晨尿首次采集可用于糖尿病患者微量白蛋白尿的诊断，尤其是在计算白蛋白/肌酐比值时。这种简单可靠的方法能够以良好的敏感性识别微量白蛋白尿患者及有发生临床肾病风险的患者。
