Somani B L, Saha T K, Arora M M, Sharma Y V
Scientist-E, Dept of Biochemistry, Armed Forces Medical College, Pune 411040.
Graded Specialist (Pathology), 160 MH, C/O 99 APO.
Med J Armed Forces India. 1995 Apr;51(2):110-116. doi: 10.1016/S0377-1237(17)30940-1. Epub 2017 Jun 26.
Albumin excretion in microalbuminuria range is one of the earliest manifestation of nephropathy, specially in diabetes mellitus. The modified dye binding method using bromo-phenol blue was studied in 27 healthy controls and 54 patients of diabetes mellitus, negative for albuminuria by albustix test. The analytical recovery (99.4 to 104.0%), within run coefficient of variation (0.8 to 0.36%) and day-to-day coefficient of variation (2.39 to 0.82%), for low and higher range were within acceptable limits. The values in controls ranged as follows: urinary albumin concentration (mg/L) 7.7 - 28.4 in 2-hour specimen and 10.3 - 29.2 in overnight specimen; albumin excretion rate (µg/min) 7.8 - 29.7 in 2-hour and 9.2 - 29.6 in overnight specimen; and albumin creatinine ratio (mg/g) 10.6 - 29.6 in 2-hour and 11.9 - 29.6 in overnight specimens. Correlation analysis of various albumin excretion parameters revealed excellent correlation between estimations from overnight and 2-hour samples for albumin-creatinine ratio (r = 1.00) and albumin excretion rate (r=0.96). Equally good correlation was observed between 2-hour albumin-creatinine ratio and albumin excretion rate (r=0.95). In 10 of 54 patients excretion rate was more than 200 µg/min and could have been detected by repeat albustix test. Of the 36 positive for microalbuminuria, 21 had one or more target organ involvement. There was no target organ involvement in 8 patients negative for microalbuminuria. Screening for microalbuminuria by this simple and economic method, using 2-hour albumin-excretion rate or albumin-creatinine ratio could be one of the earliest investigations in diabetic patients.
微量白蛋白尿范围内的白蛋白排泄是肾病最早的表现之一，在糖尿病患者中尤为如此。对27名健康对照者和54名尿白蛋白试纸检测尿白蛋白阴性的糖尿病患者，研究了使用溴酚蓝的改良染料结合法。低浓度和高浓度的分析回收率（99.4%至104.0%）、批内变异系数（0.8%至0.36%）和日间变异系数（2.39%至0.82%）均在可接受范围内。对照组的值如下：2小时标本中尿白蛋白浓度（mg/L）为7.7 - 28.4，过夜标本中为10.3 - 29.2；白蛋白排泄率（µg/min）2小时标本中为7.8 - 29.7，过夜标本中为9.2 - 29.6；白蛋白肌酐比值（mg/g）2小时标本中为10.6 - 29.6，过夜标本中为11.9 - 29.6。对各种白蛋白排泄参数的相关分析显示，过夜和2小时样本对白蛋白肌酐比值（r = 1.00）和白蛋白排泄率（r = 0.96）的估计之间具有极好的相关性。2小时白蛋白肌酐比值和白蛋白排泄率之间也观察到同样良好的相关性（r = 0.95）。54名患者中有10名的排泄率超过200 µg/min，重复尿白蛋白试纸检测本可检测到。在36名微量白蛋白尿阳性患者中，21名有一个或多个靶器官受累。8名微量白蛋白尿阴性患者无靶器官受累。通过这种简单且经济的方法，使用2小时白蛋白排泄率或白蛋白肌酐比值筛查微量白蛋白尿，可能是糖尿病患者最早进行的检查之一。
