Tada H, Takeuchi S, Takagi M, Isogai S
Second Department of Internal Medicine, Toho University School of Medicine, Tokyo.
Tohoku J Exp Med. 1987 Oct;153(2):145-50. doi: 10.1620/tjem.153.145.
We have shown previously that increased concentrations of plasma soluble fibrin monomer complexes (SFMC) and elevated fibronectin (Fn) levels are closely related to the development of diabetic microangiopathy. The purpose of the present study was to explore whether or not changes in plasma glucose levels could have an effect on these protein constituents. Plasma glucose levels of 25 uncontrolled diabetic patients were brought under control with insulin and serial measurements of SFMC and Fn were made over a period of 4 weeks. Glucose values fell from an average of 312 mg/100 ml to 160 mg/100 ml. Ten patients with macroproteinuria (i.e. greater than or equal to 0.5 g/24 hr) showed initially elevated plasma SFMC and Fn concentrations. These levels fell significantly over the 4 week observation period: from 13.6 mg/100 ml to 9.4 mg/100 ml for SFMC and from 38.4 mg/100 ml to 34.5 mg/100 ml for Fn. The remaining 15 patients had nearly normal levels of both SFMC (7.9 mg/100 ml) and Fn (31.1 mg/100 ml) and glycemic control brought no further reduction. The data indicated that a) elevated SFMC and Fn levels are indeed associated with diabetic microangiopathy, especially in the presence of macroproteinuria; and b) adequate glycemic control is capable of normalizing the plasma concentration of these constituents.
我们之前已经表明，血浆可溶性纤维蛋白单体复合物（SFMC）浓度升高和纤连蛋白（Fn）水平升高与糖尿病微血管病变的发展密切相关。本研究的目的是探讨血浆葡萄糖水平的变化是否会对这些蛋白质成分产生影响。25例血糖未得到控制的糖尿病患者通过胰岛素治疗使血糖得到控制，并在4周内连续测量SFMC和Fn。血糖值从平均312mg/100ml降至160mg/100ml。10例大量蛋白尿患者（即大于或等于0.5g/24小时）最初血浆SFMC和Fn浓度升高。在4周的观察期内，这些水平显著下降：SFMC从13.6mg/100ml降至9.4mg/100ml，Fn从38.4mg/100ml降至34.5mg/100ml。其余15例患者的SFMC（7.9mg/100ml）和Fn（31.1mg/100ml）水平几乎正常，血糖控制并未使其进一步降低。数据表明：a）SFMC和Fn水平升高确实与糖尿病微血管病变有关，尤其是在存在大量蛋白尿的情况下；b）充分的血糖控制能够使这些成分的血浆浓度恢复正常。
