Schmitz A, Gundersen H J, Osterby R
Second University Clinic of Internal Medicine, Kommunehospitalet, Aarhus, Denmark.
Diabetes. 1988 Jan;37(1):38-43. doi: 10.2337/diab.37.1.38.
We quantitated glomerular structure by light microscopy in 19 subjects with non-insulin-dependent diabetes mellitus (NIDDM) and studied the possible connection between morphology and urinary albumin concentration. Autopsy material was collected retrospectively from diabetic subjects in whom urinary albumin concentration had been measured within 1.5 yr. Nineteen consecutive sex- and age-matched nondiabetic subjects were controls. A quantitative study of a random sample of glomeruli was performed blindly on periodic acid-Schiff (PAS)-stained sections. The main parameters obtained were 1) mean volume of open glomeruli, 2) frequency of glomerular occlusion, and 3) volume fraction of red-stained material (PAS-positive substance) in open glomeruli [Vv(R/G)]. There was no increase in glomerular volume in these NIDDM subjects, contrary to the glomerular hypertrophy found early as well as late in insulin-dependent diabetes mellitus. An increase in Vv(R/G) was found in diabetic subjects, demonstrating the presence of glomerulopathy as it is diagnosed by light microscopy. The frequency of glomerular occlusion was not significantly different between the groups. A high urinary albumin concentration did not necessarily reflect more advanced glomerulopathy.
我们通过光学显微镜对19名非胰岛素依赖型糖尿病（NIDDM）患者的肾小球结构进行了定量分析，并研究了形态学与尿白蛋白浓度之间的可能联系。回顾性收集了1.5年内测量过尿白蛋白浓度的糖尿病患者的尸检材料。选取19名年龄和性别匹配的非糖尿病患者作为对照。在高碘酸-希夫（PAS）染色切片上对随机抽取的肾小球样本进行盲法定量研究。获得的主要参数为：1）开放肾小球的平均体积；2）肾小球闭塞频率；3）开放肾小球中红色染色物质（PAS阳性物质）的体积分数[Vv(R/G)]。与胰岛素依赖型糖尿病早期和晚期出现的肾小球肥大相反，这些NIDDM患者的肾小球体积没有增加。在糖尿病患者中发现Vv(R/G)增加，表明通过光学显微镜诊断存在肾小球病变。两组之间肾小球闭塞频率无显著差异。高尿白蛋白浓度不一定反映更严重的肾小球病变。
