Ghiggeri G M, Candiano G, Delfino G, Queirolo C
Diabete Metab. 1986 Apr;12(2):68-73.
In an attempt to define the nature of renal selectivity in diabetes mellitus, we have determined the free sulfhydryl (SH) groups of serum and urinary albumin in 9 normal subjects and 24 diabetic patients with various grades of renal involvement, as defined by their urinary excretion rates of albumin (alb. UER): 8 with alb. UER less than 10 micrograms/min (Group A), 6 with alb. UER between 10 and 30 micrograms/min (Group B), 5 with alb. UER between 30 and 200 micrograms/min (Group C) and 5 with alb. UER greater than 200 micrograms/min (Group D). The free SH group content of urinary albumin was three to four fold increased in comparison with its serum homologue in normal subjects and in diabetics with normal or slightly increased alb. UERs (Groups A and B). Diabetics in Group C showed a two-fold increase in free SH groups of urinary albumin compared to serum albumin and diabetics with clinical nephropathy (Group D) showed no increase at all. The SH group content of urinary albumin correlated in all diabetics with the concentration of glycosyl albumin and the of urinary/serum albumin SH groups ratio was inversely correlated with alb. UER. From these observations concerning the selectivity properties of the renal filter in normal and diabetic subjects, it is concluded that the mechanism for progression of diabetic nephropathy may be the hyperfiltration of albumin with an altered conformational state.
为了明确糖尿病患者肾脏选择性的本质，我们测定了9名正常受试者以及24名患有不同程度肾脏病变的糖尿病患者血清和尿白蛋白中的游离巯基（SH）基团，这些糖尿病患者的肾脏病变程度依据其白蛋白尿排泄率（alb. UER）来界定：8名患者的alb. UER低于10微克/分钟（A组），6名患者的alb. UER在10至30微克/分钟之间（B组），5名患者的alb. UER在30至200微克/分钟之间（C组），5名患者的alb. UER高于200微克/分钟（D组）。在正常受试者以及alb. UER正常或略有升高的糖尿病患者（A组和B组）中，尿白蛋白的游离SH基团含量相较于其血清同源物增加了三到四倍。C组糖尿病患者尿白蛋白的游离SH基团含量相较于血清白蛋白增加了两倍，而患有临床肾病的糖尿病患者（D组）则完全没有增加。所有糖尿病患者尿白蛋白的SH基团含量与糖基化白蛋白浓度相关，尿/血清白蛋白SH基团比值与alb. UER呈负相关。基于这些关于正常和糖尿病受试者肾脏滤过选择性特性的观察结果，可以得出结论：糖尿病肾病进展的机制可能是构象改变的白蛋白超滤。
