Lee I K, Park K Y, Oh H K, Park R W, Jo J S
Department of Internal Medicine, School of Medicine, Keimyung University, Korea.
J Korean Med Sci. 1994 Aug;9(4):341-6. doi: 10.3346/jkms.1994.9.4.341.
In diabetes mellitus, thickening of basement membrane in capillaries and small vessels is a well-known finding and important in the progression of diabetic microangiopathy. We evaluated whether the plasma levels of type IV collagen and fibronectin, which are important factors of basement membrane, are related with the presence of diabetic microangiopathy. Plasma type IV collagen and fibronectin levels were measured in 40 healthy controls (Mean +/- SD, age; 50.3 +/- 5.5 yr) and 94 diabetic patients (age; 52.4 +/- 13.5 yr) with and without microvascular complications. The mean plasma levels of type IV collagen (5.3 +/- 2.9 ng/ml) and fibronectin (474.4 +/- 119.4 ug/ml) in diabetic patients were significantly higher (p < 0.01) than in healthy controls (3.7 +/- 1.3 ng/ml and 319 +/- 50.9 ug/ml). The mean plasma level of type IV collagen in diabetic patients with complications (6.6 +/- 3.7 ng/ml) was significantly higher (p < 0.01) than in those without complications (4.3 +/- 1.7 ng/ml) and became higher in more complicated patients. Furthermore, the severity of retinopathy and several indicators of nephropathy such as serum BUN, creatinine and proteinuria were closely associated with plasma type IV collagen level and a significant correlation was found between plasma type IV collagen and creatinine clearance (r = -0.31, p < 0.001). There was no significant difference in plasma fibronectin concentrations, however, between the diabetic patients with complications and those without complications.(ABSTRACT TRUNCATED AT 250 WORDS)
在糖尿病中,毛细血管和小血管基底膜增厚是一个众所周知的现象,并且在糖尿病微血管病变的进展中起重要作用。我们评估了作为基底膜重要成分的IV型胶原蛋白和纤连蛋白的血浆水平是否与糖尿病微血管病变的存在有关。对40名健康对照者(平均±标准差,年龄;50.3±5.5岁)和94名有或无微血管并发症的糖尿病患者(年龄;52.4±13.5岁)测量了血浆IV型胶原蛋白和纤连蛋白水平。糖尿病患者的IV型胶原蛋白平均血浆水平(5.3±2.9 ng/ml)和纤连蛋白(474.4±119.4 μg/ml)显著高于健康对照者(3.7±1.3 ng/ml和319±50.9 μg/ml)(p<0.01)。有并发症的糖尿病患者的IV型胶原蛋白平均血浆水平(6.6±3.7 ng/ml)显著高于无并发症者(4.3±1.7 ng/ml)(p<0.01),且在并发症更多的患者中更高。此外,视网膜病变的严重程度以及肾病的几个指标如血清尿素氮、肌酐和蛋白尿与血浆IV型胶原蛋白水平密切相关,并且血浆IV型胶原蛋白与肌酐清除率之间存在显著相关性(r = -0.31,p<0.001)。然而,有并发症的糖尿病患者和无并发症的糖尿病患者之间血浆纤连蛋白浓度没有显著差异。(摘要截断于250字)