Shichiri M, Iwamoto H, Shiigai T
Arch Intern Med. 1987 Feb;147(2):225-8.
In diabetes, the serum uric acid level is low due to increased urate clearance; however, its mechanism remains unknown. We examined seven maturity-onset diabetic patients with rarely reported hypouricemia due to renal tubular abnormality to better understand the renal handling of urate by the diabetic kidney. The results of studies indicate that the increase in urate clearance was entirely accounted for by increased pyrazinamide-suppressible urate clearance. The maximal uricosuric response to probenecid administration was exaggerated. The effects of drugs on urate clearance were similar to those we have previously reported in the syndrome of inappropriate secretion of antidiuretic hormone. In four patients, the family survey did not reveal anyone with hypouricemia. These observations suggest that hypouricemia due to hyperuricosuria, which responds markedly to pyrazinamide and probenecid, is actually an indicator of renal tubular abnormality in diabetics.
在糖尿病中，由于尿酸盐清除率增加，血清尿酸水平较低；然而，其机制尚不清楚。我们检查了7例成年起病的糖尿病患者，这些患者因肾小管异常而出现罕见的低尿酸血症，以便更好地了解糖尿病肾脏对尿酸的处理情况。研究结果表明，尿酸盐清除率的增加完全是由吡嗪酰胺可抑制的尿酸盐清除率增加所致。给予丙磺舒后最大尿酸排泄反应增强。药物对尿酸盐清除率的影响与我们之前在抗利尿激素分泌不当综合征中报道的相似。在4例患者中，家族调查未发现有低尿酸血症的人。这些观察结果表明，对吡嗪酰胺和丙磺舒有明显反应的高尿酸尿导致的低尿酸血症实际上是糖尿病患者肾小管异常的一个指标。
