Fox J G, Quin J D, Paterson K R, O'Reilly D S, Smith M P, Boulton-Jones J M
Renal Unit, Royal Infirmary, Glasgow, UK.
Diabet Med. 1995 May;12(5):387-91. doi: 10.1111/j.1464-5491.1995.tb00500.x.
Glomerular charge selectivity was assessed using the ratio of the clearance of pancreatic isoamylase to the clearance of the more anionic salivary isoamylase (CPAm/CSAm) in 12 normal subjects and 50 patients with Type 1 diabetes: 13 with normal albumin excretion and short duration of diabetes (< 5 years), 15 with normal albumin excretion and long duration of diabetes (> 15 years), 13 with microalbuminuria, and 9 with clinical nephropathy. None had serum creatinine > 200 mumol l-1. There were no significant differences in CPAm/CSAm between the normal subjects and the two groups of normoalbuminuric patients with Type 1 diabetes. CPAm/CSAm was significantly lower in diabetic patients with microalbuminuria or clinical nephropathy than in normoalbuminuric patients with Type 1 diabetes. When the 37 patients with normoalbuminuria and long-standing diabetes, microalbuminuria, and nephropathy were considered together, there was a significant negative correlation between CPAm/CSAm and albumin excretion rate (rs = 0.71, p < 0.001). Progressive impairment of glomerular charge selectivity at the molecular size of amylase (molecular mass 56 kDa) accompanies increasing albuminuria in Type 1 diabetes.
在12名正常受试者和50名1型糖尿病患者中，通过胰腺异淀粉酶清除率与阴离子性更强的唾液异淀粉酶清除率之比（CPAm/CSAm）来评估肾小球电荷选择性：13名白蛋白排泄正常且糖尿病病程短（<5年），15名白蛋白排泄正常且糖尿病病程长（>15年），13名微量白蛋白尿患者，以及9名临床肾病患者。所有患者血清肌酐均≤200μmol/L。正常受试者与两组白蛋白排泄正常的1型糖尿病患者的CPAm/CSAm无显著差异。微量白蛋白尿或临床肾病的糖尿病患者的CPAm/CSAm显著低于白蛋白排泄正常的1型糖尿病患者。当将37名白蛋白排泄正常且患有长期糖尿病、微量白蛋白尿和肾病的患者合并考虑时，CPAm/CSAm与白蛋白排泄率之间存在显著负相关（rs = 0.71，p < 0.001）。在1型糖尿病中，随着白蛋白尿增加，淀粉酶分子大小（分子量56 kDa）的肾小球电荷选择性逐渐受损。
