Kern T S, Engerman R L
Department of Ophthalmology, University of Wisconsin, Madison.
Diabetologia. 1988 Dec;31(12):928-32. doi: 10.1007/BF00265379.
The relationship between urinary protein excretion and control of diabetes was evaluated in alloxan-diabetic dogs prospectively assigned to poor, moderate, or good glycaemic control. Protein excretion rate increased with the duration of insulin deficiency, and was significantly greater than normal in the poor control group by the fourth year of diabetes. Appreciable differences in the severity of the proteinuria were observed among animals of the poor and moderate glycaemic control groups; some of the animals excreted in excess of 500 mg protein/24 h while others excreted no more than normal throughout the 5 years of study. Differences in glycaemic control among these insulin-deficient animals seem not sufficient to account for the observed differences in protein excretion. Immunoassay for albumin indicated that the defect resulting in supranormal protein excretion was at least partly glomerular in origin. Good glycaemic control prevented the protein loss from exceeding normal. A potential role of hyperglycaemia in the development of proteinuria was examined in nondiabetic dogs made experimentally hyperglycaemic with galactose. Consumption of a 30% galactose diet for up to 5 years duration had little influence on protein excretion.
对前瞻性地分为血糖控制差、中等或良好的四氧嘧啶糖尿病犬，评估其尿蛋白排泄与糖尿病控制之间的关系。蛋白排泄率随胰岛素缺乏持续时间增加，到糖尿病第四年时，血糖控制差的组明显高于正常水平。血糖控制差和中等的组动物之间，蛋白尿严重程度存在明显差异；在整个5年研究期间，一些动物蛋白排泄超过500mg/24小时，而另一些动物排泄不超过正常水平。这些胰岛素缺乏动物的血糖控制差异似乎不足以解释观察到的蛋白排泄差异。白蛋白免疫测定表明，导致蛋白排泄超常的缺陷至少部分源于肾小球。良好的血糖控制可防止蛋白丢失超过正常水平。在通过半乳糖实验性造成高血糖的非糖尿病犬中，研究了高血糖在蛋白尿发生中的潜在作用。食用30%半乳糖饮食长达5年对蛋白排泄影响很小。
