Deckert T, Egeberg J, Frimodt-Møller C, Sander E, Svejgaard A
Diabetologia. 1979 Aug;17(2):91-6. doi: 10.1007/BF01222208.
The study was designed to show whether there was any relation between muscle capillary basement membrane thickness, HLA-antigens, anti-insulin antibodies and proliferative retinopathy. Electron microscopic measurements of muscle capillary basement membrane thickness were performed on muscle biopsies from 15 insulin-dependent diabetics and severe proliferative retinopathy, 24 insulin-dependent diabetics with minimal retinopathy and 18 age- and sex matched non-diabetics. All the patients had had diabetes for 20 years or more. None had biochemical or clinical evidence of diabetic nephropathy. Basement membrane thickness was measured according to the methods of Siperstein and Williamson. Muscle capillary basement membrane thickening occurred in 32 of 39 diabetics, using the Siperstein method, but patients with proliferative retinopathy did not exhibit thicker basement membranes than patients with no or minimal changes in the retina. There were apparent differences in HLA-antigens between diabetics with and without proliferative retinopathy, but they did not reach statistical significance. There was no correlation between muscle capillary basement membrane thickness and the quantity of insulin antibodies. The results indicate that factors other than basement membrane thickening and genetic factors in the HLA-region, are responsible for the development of proliferative retinopathy.
该研究旨在表明肌肉毛细血管基底膜厚度、HLA抗原、抗胰岛素抗体与增殖性视网膜病变之间是否存在任何关联。对15例胰岛素依赖型糖尿病伴严重增殖性视网膜病变患者、24例胰岛素依赖型糖尿病伴轻微视网膜病变患者以及18例年龄和性别匹配的非糖尿病患者的肌肉活检标本进行了肌肉毛细血管基底膜厚度的电子显微镜测量。所有患者的糖尿病病程均在20年及以上。无一例有糖尿病肾病的生化或临床证据。基底膜厚度按照Siperstein和Williamson的方法进行测量。采用Siperstein方法,39例糖尿病患者中有32例出现肌肉毛细血管基底膜增厚,但增殖性视网膜病变患者的基底膜厚度并不比视网膜无变化或轻微变化的患者厚。有增殖性视网膜病变和无增殖性视网膜病变的糖尿病患者之间的HLA抗原存在明显差异,但未达到统计学意义。肌肉毛细血管基底膜厚度与胰岛素抗体量之间无相关性。结果表明,增殖性视网膜病变的发生是由基底膜增厚和HLA区域的遗传因素以外的其他因素所致。