McAuliffe A V, Fisher E J, McLennan S V, Yue D K, Turtle J R
Department of Life Sciences, University of Sydney, New South Wales, Australia.
Diabet Med. 1996 Aug;13(8):758-63. doi: 10.1002/(SICI)1096-9136(199608)13:8<758::AID-DIA160>3.0.CO;2-T.
Nephropathy is a serious microvascular complication of diabetes mellitus which is preceded by a period of microalbuminura. Increased loss of proteoglycan (PG) from glomerular basement (GBM) has been postulated to alter glomerular charge selectivity which contributes to urinary loss of albumin. In this study we measured the excretion of urinary glycosaminoglycans (GAG), the degradation products of PG, in 82 non-insulin-dependent (NIDDM) (Type 2) diabetic and 34 non-diabetic subjects. We found that diabetic subjects had a significantly higher GAG urinary excretion rate compared to non-diabetic subjects (12.54 +/- 5.67 vs 8.80 +/- 3.99 micrograms glucuronic acid min-1, p = 0.0001). Categorizing for albuminuric status shows that the diabetic normo-, micro- and macroalbuminuric groups have a higher GAG excretion rate than non-diabetic subjects. Heparan sulphate (HS) GAG urinary excretion was measured in 25 samples from diabetic subjects and 18 non-diabetic subjects. Diabetic subjects excreted more HS GAG than controls both as a rate or as a percentage of total GAG (3.70 +/- 1.94 vs 2.38 +/- 1.48 micrograms glucosamine min-1, p = 0.02; 31.6% +/- 12.5 vs 23.1% +/- 10.4, p = 0.02). Categorizing for albuminuric status shows that micro- and macro-albuminuric groups have a significantly higher HS GAG excretion rate than non-diabetic subjects. We conclude that, as in IDDM, excretion of GAG and HS GAG is higher in NIDDM and may precede the development of microalbuminuria.
肾病是糖尿病严重的微血管并发症，在此之前会经历一段微量白蛋白尿期。据推测，肾小球基底膜（GBM）中蛋白聚糖（PG）损失增加会改变肾小球电荷选择性，进而导致白蛋白尿流失。在本研究中，我们测量了82名非胰岛素依赖型（NIDDM）（2型）糖尿病患者和34名非糖尿病受试者尿中糖胺聚糖（GAG）（PG的降解产物）的排泄量。我们发现，与非糖尿病受试者相比，糖尿病患者的GAG尿排泄率显著更高（12.54±5.67对8.80±3.99微克葡萄糖醛酸每分钟，p = 0.0001）。根据白蛋白尿状态分类显示，糖尿病正常白蛋白尿、微量白蛋白尿和大量白蛋白尿组的GAG排泄率均高于非糖尿病受试者。我们对25名糖尿病受试者和18名非糖尿病受试者的样本测量了硫酸乙酰肝素（HS）GAG尿排泄量。糖尿病受试者排泄的HS GAG无论是速率还是占总GAG的百分比都高于对照组（3.70±1.94对2.38±1.48微克葡萄糖胺每分钟，p = 0.02；31.6%±12.5对23.1%±10.4，p = 0.02）。根据白蛋白尿状态分类显示，微量和大量白蛋白尿组的HS GAG排泄率显著高于非糖尿病受试者。我们得出结论，与胰岛素依赖型糖尿病（IDDM）一样，非胰岛素依赖型糖尿病（NIDDM）患者中GAG和HS GAG排泄量更高，且可能先于微量白蛋白尿的发生。
