Bjørgaas M, Vik T, Sager G, Sagen E, Jorde R
Department of Clinical Chemistry, University Hospital of Trondheim, Norway.
Scand J Clin Lab Invest. 1997 Dec;57(8):711-8. doi: 10.3109/00365519709105233.
The urinary excretion of non-conjugated adrenaline and noradrenaline during hypoglycaemic clamp was investigated in 16 diabetic and 15 non-diabetic adolescents. In the diabetic adolescents, the mean excretion of adrenaline was approximately nine times higher in clamp urine than in morning urine (p < 0.0001). In the non-diabetic adolescents, the mean excretion of adrenaline was 20-30 times higher in clamp urine than in morning urine (p < 0.0001). Plasma catecholamines were measured, and the area under the plasma concentration-time curve (AUC) and renal clearance of catecholamines were calculated. There was a linear correlation between the AUC and the urinary excretion of adrenaline (r = 0.57, p = 0.001) and noradrenaline (r = 0.49, p = 0.006) during the hypoglycaemic clamp. The renal clearance of adrenaline and noradrenaline did not differ between the diabetic and non-diabetic subjects. In the diabetic group, there was a positive correlation between HbA1c and the adrenaline excretion in clamp urine (r = 0.60, p = 0.015). The eight diabetic subjects with HbA1c < 10% had lower adrenaline excretion in clamp urine than the subjects with HbA1c > 10% and the non-diabetic subjects (all p values < 0.05). We conclude that there is a marked increase in urinary adrenaline excretion during hypoglycaemia in diabetic and non-diabetic adolescents. The increase in adrenaline excretion during hypoglycaemia was attenuated in the better-controlled diabetic adolescents in our study.
对16名糖尿病青少年和15名非糖尿病青少年在低血糖钳夹试验期间非结合肾上腺素和去甲肾上腺素的尿排泄情况进行了研究。在糖尿病青少年中，钳夹尿液中肾上腺素的平均排泄量比晨尿高约9倍（p < 0.0001）。在非糖尿病青少年中，钳夹尿液中肾上腺素的平均排泄量比晨尿高20 - 30倍（p < 0.0001）。测量了血浆儿茶酚胺，并计算了血浆浓度 - 时间曲线下面积（AUC）和儿茶酚胺的肾清除率。在低血糖钳夹试验期间，AUC与肾上腺素（r = 0.57，p = 0.001）和去甲肾上腺素（r = 0.49，p = 0.006）的尿排泄之间存在线性相关性。糖尿病和非糖尿病受试者之间肾上腺素和去甲肾上腺素的肾清除率没有差异。在糖尿病组中，糖化血红蛋白（HbA1c）与钳夹尿液中肾上腺素排泄之间存在正相关（r = 0.60，p = 0.015）。8名HbA1c < 10%的糖尿病受试者钳夹尿液中肾上腺素排泄低于HbA1c > 10%的受试者和非糖尿病受试者（所有p值 < 0.05）。我们得出结论，糖尿病和非糖尿病青少年在低血糖期间尿肾上腺素排泄显著增加。在我们的研究中，血糖控制较好的糖尿病青少年低血糖期间肾上腺素排泄的增加有所减弱。
