Gruden G, Pagano G, Romagnoli R, Frezet D, Olivetti C, Cavallo-Perin P
Institute of Internal Medicine, University of Turin, Italy.
Diabet Med. 1995 Mar;12(3):258-60. doi: 10.1111/j.1464-5491.1995.tb00468.x.
Thrombomodulin (TM) plays an important role in the regulation of blood coagulation at the endothelial surface. TM is also present in plasma, where an increase of its level seems to reflect endothelial damage. Since microalbuminuria is associated with an increased atherothrombotic risk and is considered an expression of widespread vascular damage, we evaluated plasma thrombomodulin levels, blood pressure, and plasma lipid values in Type 1 diabetic patients with micro- and normoalbuminuria. Thrombomodulin was measured in 12 microalbuminuric (albumin excretion rate 20-200 micrograms min-1 in 2 of 3 overnight urine collections) and in 12 normoalbuminuric (albumin excretion rate < 20 micrograms min-1) Type 1 diabetic patients matched for age, sex, body mass index, smoking habits, diabetes duration, and glycated haemoglobin. Mean thrombomodulin was significantly higher in micro- than in normalbuminuric group (59.34 +/- 3.58 vs 43.56 +/- 3.52 ng ml-1 p < 0.01). Systolic and diastolic blood pressure were significantly higher in micro- than in normoalbuminuric group (p < 0.05). There was a positive correlation between plasma thrombomodulin and albumin excretion rate (p = 0.013, r = 0.49), and between thrombomodulin and diastolic blood pressure (p = 0.023, r = 0.46) in diabetic patients as a whole but not in the individual groups. These findings suggest the presence of an endothelial injury in microalbuminuric patients.
血栓调节蛋白（TM）在内皮表面的血液凝固调节中起重要作用。TM也存在于血浆中，其水平升高似乎反映了内皮损伤。由于微量白蛋白尿与动脉粥样硬化血栓形成风险增加相关，且被认为是广泛血管损伤的一种表现，我们评估了1型糖尿病微量白蛋白尿和正常白蛋白尿患者的血浆血栓调节蛋白水平、血压和血浆脂质值。对12例微量白蛋白尿患者（3次夜间尿液收集中有2次白蛋白排泄率为20 - 200微克/分钟）和12例正常白蛋白尿患者（白蛋白排泄率<20微克/分钟）进行了血栓调节蛋白检测，这些患者在年龄、性别、体重指数、吸烟习惯、糖尿病病程和糖化血红蛋白方面相匹配。微量白蛋白尿组的平均血栓调节蛋白水平显著高于正常白蛋白尿组（59.34±3.58对43.56±3.52纳克/毫升，p<0.01）。微量白蛋白尿组的收缩压和舒张压显著高于正常白蛋白尿组（p<0.05）。在整个糖尿病患者中，血浆血栓调节蛋白与白蛋白排泄率之间存在正相关（p = 0.013，r = 0.49），血栓调节蛋白与舒张压之间也存在正相关（p = 0.023，r = 0.46），但在各个组中不存在这种相关性。这些发现表明微量白蛋白尿患者存在内皮损伤。
