Johansson B L, Berg U, Bohlin A B, Lefvert A K, Freyschuss U
Clin Sci (Lond). 1987 May;72(5):611-20. doi: 10.1042/cs0720611.
Exercise-induced changes in renal haemodynamics, water homoeostasis, urinary albumin excretion and their possible relation to plasma noradrenaline were studied in seven insulin-dependent diabetic children and adolescents without signs of autonomic or somatic neuropathy. Six age-matched clinically healthy patients in remission from the minimal change nephrotic syndrome served as controls. The diabetic patients had a higher glomerular filtration rate and effective renal plasma flow and a lower venous plasma noradrenaline level in the basal state. They also had a higher systolic blood pressure compared with the controls. During exercise the diabetic patients showed a less marked reduction in glomerular filtration rate and urinary flow and a greater increase in filtration fraction. Their heart rate increase during exercise was lower. An inverse correlation between the percentage changes in noradrenaline and glomerular filtration rate during exercise was noted solely in the diabetic patients. They also showed a less marked increase in the ratio between potassium and sodium clearances during and 20 min after exercise. Albumin excretion did not differ between the two groups. We suggest that the sympatho-adrenergic effects of exercise on heart rate, renal haemodynamics and water homoeostasis are blunted in our diabetic patients. Hence, signs of impaired sympathetic activity might be disclosed in young diabetic patients with a disease of fairly short duration.
在7名无自主神经或躯体神经病变迹象的胰岛素依赖型糖尿病儿童和青少年中，研究了运动引起的肾血流动力学、水稳态、尿白蛋白排泄变化及其与血浆去甲肾上腺素的可能关系。6名年龄匹配、临床健康且已从微小病变肾病综合征缓解的患者作为对照。糖尿病患者在基础状态下肾小球滤过率和有效肾血浆流量较高，静脉血浆去甲肾上腺素水平较低。与对照组相比，他们的收缩压也较高。运动期间，糖尿病患者的肾小球滤过率和尿流量降低不明显，滤过分数增加幅度更大。他们运动期间的心率增加较低。仅在糖尿病患者中观察到运动期间去甲肾上腺素变化百分比与肾小球滤过率之间呈负相关。他们在运动期间及运动后20分钟钾与钠清除率之比的增加也不明显。两组之间的白蛋白排泄无差异。我们认为，运动对心率、肾血流动力学和水稳态的交感 - 肾上腺素能作用在我们的糖尿病患者中减弱。因此，在病程较短的年轻糖尿病患者中可能会发现交感神经活动受损的迹象。
