Ohno T, Kato N, Shimizu M, Ishii C, Ito Y, Tomono S, Kawazu S, Murata K
Second Department of Internal Medicine, Gunma University School of Medicine, Japan.
Diabetes Res. 1993;22(3):115-21.
To study the relationship between aging and development of diabetic nephropathy, we studied the time until the development of microalbuminuria in old onset (> 50 years old, n = 21) and young onset (< 40 years old, n = 26), normotensive NIDDM patients. Microalbuminuria which is associated with the early stage of diabetic nephropathy was defined as urinary albumin index (UAI; mg/g.creatinine) of more than 10mg/g.creatinine, using timed overnight urine. In these two groups, there were no significant differences in duration of diabetes, observation periods, glycemic control, systolic diastolic blood pressure, body mass index and creatinine clearance at the time of the last observation. Mean UAI +/- standard deviation of the two groups were 37.5 +/- 78.2 mg/g.cr and 93.0 +/- 127.2 mg/g.cr in the young onset group and the old onset group, and prevalences of microalbuminuria were 38% and 76% in the young onset and old onset group, respectively. Thus, UAI and prevalence of microalbuminuria in the old onset group are significantly higher than those of the young onset group (P < 0.05). These results suggest that aging, in itself, is one of the significant risk factors for the development of diabetic nephropathy in NIDDM patients.
为研究衰老与糖尿病肾病发生之间的关系,我们对老年发病(>50岁,n = 21)和青年发病(<40岁,n = 26)的血压正常的非胰岛素依赖型糖尿病(NIDDM)患者出现微量白蛋白尿的时间进行了研究。采用过夜定时尿,将与糖尿病肾病早期相关的微量白蛋白尿定义为尿白蛋白指数(UAI;mg/g肌酐)超过10mg/g肌酐。在这两组患者中,糖尿病病程、观察期、血糖控制、收缩压、舒张压、体重指数以及最后一次观察时的肌酐清除率均无显著差异。青年发病组和老年发病组的平均UAI±标准差分别为37.5±78.2mg/g肌酐和93.0±127.2mg/g肌酐,微量白蛋白尿的患病率在青年发病组和老年发病组中分别为38%和76%。因此,老年发病组的UAI和微量白蛋白尿患病率显著高于青年发病组(P<0.05)。这些结果表明,衰老本身是非胰岛素依赖型糖尿病患者发生糖尿病肾病的重要危险因素之一。