Mangili R, Zerbini G, Barlassina C, Cusi D, Pozza G
Department of Medicine, University of Milan, Italy.
Kidney Int. 1993 Jul;44(1):127-33. doi: 10.1038/ki.1993.222.
Elevated erythrocyte sodium-lithium countertransport (SLC) activity is an intermediate phenotype of essential hypertension among Caucasians, and is controversially associated with nephropathy in Type 1 (insulin-dependent) diabetes. Hypertriglyceridemia is a frequent concomitant of elevated SLC in the general population, and may be found in diabetic nephropathy. The present study was designed to investigate the influence of kidney disease, serum triglycerides and blood pressure on the interindividual variability of SLC in Type 1 diabetes. SLC and fasting major serum lipids were studied in 35 Type 1 diabetic patients with persistently elevated urinary albumin excretion and in a group of patients matched for age, sex and duration of diabetes, but with normoalbuminuria. SLC was elevated in patients with clinical nephropathy (N = 10; median: 420 mumol.1RBC-1.hr-1) and in patients with microalbuminuria (N = 25; median: 405 mumol.1RBC-1.hr-1) compared with normoalbuminuric patients (median: 296 mumol.1RBC-1.hr-1; P < 0.01 vs. both groups). Hypertriglyceridemia and hypercholesterolemia were found only among patients with macroalbuminuria. Analysis of covariance indicated that the association of elevated SLC with kidney disease (P < 0.006 in all models) was largely independent of serum triglycerides, but also of total cholesterol, insulin dose and measures of glycemic control. Only diastolic blood pressure was positively associated with SLC (P < 0.02) independently from nephropathy (P < 0.005) also after restricting analysis to the normoalbuminuric patients. Kidney disease and raised blood pressure remain major concomitants of elevated SLC in Type 1 diabetics.
红细胞钠-锂逆向转运（SLC）活性升高是白种人原发性高血压的一种中间表型，并且与1型（胰岛素依赖型）糖尿病肾病存在争议性关联。高甘油三酯血症是普通人群中SLC升高的常见伴随情况，也可能出现在糖尿病肾病中。本研究旨在调查肾脏疾病、血清甘油三酯和血压对1型糖尿病患者个体间SLC变异性的影响。对35例持续性尿白蛋白排泄升高的1型糖尿病患者以及一组年龄、性别和糖尿病病程相匹配但尿白蛋白正常的患者进行了SLC和空腹主要血清脂质研究。与尿白蛋白正常的患者（中位数：296 μmol·1RBC⁻¹·hr⁻¹）相比，临床肾病患者（N = 10；中位数：420 μmol·1RBC⁻¹·hr⁻¹）和微量白蛋白尿患者（N = 25；中位数：405 μmol·1RBC⁻¹·hr⁻¹）的SLC升高（与两组相比，P < 0.01）。仅在大量白蛋白尿患者中发现高甘油三酯血症和高胆固醇血症。协方差分析表明，SLC升高与肾脏疾病的关联（在所有模型中P < 0.006）在很大程度上独立于血清甘油三酯，也独立于总胆固醇、胰岛素剂量和血糖控制指标。仅舒张压与SLC呈正相关（P < 0.02），在将分析限制于尿白蛋白正常的患者后，也独立于肾病（P < 0.005）。肾脏疾病和血压升高仍然是1型糖尿病患者SLC升高的主要伴随情况。
