Kanauchi M, Nishioka H, Dohi K
First Department of Internal Medicine, Nara Medical University, Japan.
Nihon Jinzo Gakkai Shi. 1995 Feb;37(2):127-33.
We evaluated the diagnostic utility of urinary fibronectin (FN) in patients with diabetic nephropathy by comparing the findings with those of renal biopsy specimens. A total of 46 diabetic patients were divided into four groups, D0, DI, DII and DIII-IV, according to the severity of diffuse glomerular lesions using Gellman's criteria. Using 24-hour urine specimens, FN was measured by a solid phase enzyme-linked immunosorbent assay. The urinary excretion of FN was significantly higher in the overt proteinuric group than in the normo- and micro-albuminuric groups. Urinary FN level showed a significant increase with respect to the progress of glomerular diffuse lesions. There was a weak correlation between the urinary level of FN and serum creatinine level and a weak inverse correlation between the urinary level of FN and creatinine clearance. When patients with overt proteinuria were excluded from the analysis, there was no correlation between the urinary level of FN and serum creatinine level, creatinine clearance, or that of beta 2-microglobulin and NAG. The findings indicate that urinary FN may be useful in estimating pathologic conditions, especially the early stage of diabetic nephropathy.
我们通过将结果与肾活检标本的结果进行比较，评估了尿纤连蛋白（FN）在糖尿病肾病患者中的诊断效用。根据Gellman标准，将46例糖尿病患者按照弥漫性肾小球病变的严重程度分为四组：D0、D1、DII和DIII-IV组。使用24小时尿液标本，通过固相酶联免疫吸附测定法测量FN。显性蛋白尿组的尿FN排泄量显著高于正常白蛋白尿组和微量白蛋白尿组。尿FN水平随肾小球弥漫性病变的进展而显著升高。尿FN水平与血清肌酐水平之间存在弱相关性，与肌酐清除率之间存在弱负相关性。当将显性蛋白尿患者排除在分析之外时，尿FN水平与血清肌酐水平、肌酐清除率、β2-微球蛋白水平和NAG之间均无相关性。这些结果表明，尿FN可能有助于评估病理状况，尤其是糖尿病肾病的早期阶段。
