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Query: UMLS:C0011849 (
diabetes
)
277,896
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
We compared the urinary excretion of albumin, transferrin, N-acetyl-beta-D-glucosaminidase and
alpha-1-microglobulin
in 78 Type 1 (insulin-dependent) diabetic patients: 39 with retinopathy and 39 without. The two groups were matched for age, sex and duration of
diabetes
. The patients with retinopathy had increased excretion (median and range) of albumin [1.7(0.3-399.1) versus 1.0(0.3-116.6) mg/mmol creatinine, P less than 0.05], transferrin [114.2 (4.1-37126.2) versus 33.4 (1.0-4176.7) micrograms/mmol creatinine, P less than 0.01] and N-acetyl-beta-D-glucosaminidase [23.8 (1.1-119.1) versus 15.0 (0.1-65.1) mumol/h/mmol creatinine, P less than 0.05] but not
alpha-1-microglobulin
. Transferrin excretion correlated with albumin excretion. The prevalence of increased transferrin excretion (transferrinuria) was greater than that of microalbuminuria in patients both with and without retinopathy (P less than 0.01 in both cases). Urinary transferrin seems likely to be predominantly of glomerular origin and merits prospective longitudinal evaluation as a potential index of the microangiopathic process.
...
PMID:Glomerular and tubular proteinuria in type 1 (insulin-dependent) diabetic patients with and without retinopathy. 137 79
AMBP
measurements were obtained at 20-min intervals during the day and at 60-min intervals during the night in 38 adolescents and young adults (12-25 yr old) with type I
diabetes
, and in 36 healthy, nondiabetic control subjects of comparable age. The group of patients with elevated AER (greater than 15 micrograms/min) had higher mean 24-h sBP, dBP, and BPB (defined as the prevalence of systolic readings greater than 130 mm Hg or diastolic readings greater than 85 mm Hg) compared with both the group of patients with type I
diabetes
and AER less than 15, and the control group. The normal diurnal variation in BP and BPB was observed in the control group and the group with type I
diabetes
and AER less than 15, whereas the nocturnal decrease observed in the group with type I
diabetes
and AER greater than 15 was not statistically significant. Elevations in
AMBP
of the patient group with AER greater than 15 were reflected in random BP measurements. Even though the mean random BP measurements of all groups were within the normal range for age, the mean random sBP and dBP of the type I
diabetes
patients with AER greater than 15 was higher than both the control group and the group with type I
diabetes
and AER less than 15. The GFR, determined by the clearance of 99Tc-DTPA, was associated negatively with measures of
AMBP
and AER in the group with AER greater than 15.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes
1992 Sep
PMID:Ambulatory blood pressure in type I diabetes mellitus. Comparison to presence of incipient nephropathy in adolescents and young adults. 149 55
Glomerular and tubular microproteinuria precede the development of overt nephropathy in Type 1 diabetes mellitus. However, in Type 2
diabetes
urinary protein excretion and its relationship to diabetic nephropathy has not been clearly characterized. Twenty consecutive, newly diagnosed patients with Type 2
diabetes
, whose urine was Albustix-negative and sterile on culture, were studied. Two timed overnight urine samples were collected at diagnosis, and after 2 months and 2 years, and excretion rates of albumin,
alpha-1-microglobulin
and N-acetyl-beta-D-glucosaminidase were calculated. HbA1c fell from 12.1 +/- 2.4% at diagnosis to 9.5 +/- 1.5% at 2 months and 9.6 +/- 2.2% at 2 years. Albumin excretion rate fell marginally from 6.5 (2.1-242.5) micrograms min-1 at diagnosis to 5.5 (1.7-274.0) micrograms min-1 at 2 months (p less than 0.05) rising again to 6.1 (1.9-201.7) micrograms min-1 at 2 years. alpha-1-Microglobulin excretion rate fell from 13.5 (3.6-59.9) micrograms min-1 at diagnosis to 8.4 (2.9-16.1) micrograms min-1 at 2 months and 8.8 (1.8-54.1) micrograms min-1 at 2 years (both p less than 0.05). Albumin excretion rate was found to correlate significantly with creatinine clearance at diagnosis (rs = 0.61, p less than 0.005), though not subsequently. In contrast, excretion rates of
alpha-1-microglobulin
and N-acetyl-beta-D-glucosaminidase correlated with HbA1c (rs = 0.68 and 0.66, respectively, p less than 0.005 at diagnosis and rs = 0.57 and 0.53, p less than 0.05 subsequently in both cases).(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Microproteinuria in type 2 diabetes mellitus from diagnosis. 169 21
Bedside methods for the detection of microalbuminuria such as Microbumintest (TM) have the advantage of simplicity but not the specificity of radio-immunoassay. In the present study we assessed whether apparently inappropriate positive Microbumintest results in the presence of low urinary albumin concentrations could be accounted for by non-albumin proteinuria of glomerular or renal tubular origin. Urinary albumin and transferrin were considered to indicate glomerular proteinuria, and
alpha-1-microglobulin
and N-acetyl-beta-D-glucosaminidase to reflect tubular proteinuria. Microbumintest had a sensitivity of 100% and specificity of 67% to detect a urinary albumin concentration of 40 mg/l. Samples with albumin concentration less than 40 mg/l contained more total protein: 110 (78-155) v 60 (35-104) mg/l p less than 0.0001 (geometric means with 1 SD range), more albumin: 11.7 (5.1-26.8) v 5.4 (2.8-10.4) mg/l p less than 0.005 and more transferrin: 496 (191-1284) v 174 (78-389) micrograms/l p less than 0.001, in those testing positive with Microbumintest than in those testing negative. Microbumintest had a sensitivity of 82% and specificity of 75% to detect an albumin concentration of 20 mg/l. In samples containing less than or equal to 20 mg/l albumin, the mean albumin concentration was no greater in those testing positive compared with those testing negative. However, total protein: 108 (72-161) v 60 (34-105) mg/l p less than 0.001, and transferrin: 326 (148-715) v 157 (78-316) micrograms/l p = 0.01 both remained increased in samples testing positive compared with those testing negative.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes
Res 1990 Aug
PMID:Microbumintest and non-albumin proteinuria in diabetes. 172 Mar 63
Urinary excretion rates of transferrin, albumin, N-acetyl-beta-D-glucosaminidase (NAG) and
alpha-1-microglobulin
(A1M) were measured in type 2 (non-insulin-dependent) diabetic patients at diagnosis and after 6 and 12 weeks treatment. Initially 21 (53%) patients had elevated transferrin excretion rates. The proportion of patients with raised transferrin excretion rates fell to 30% at 6 weeks and 20% at 12 weeks with treatment of
diabetes
. At diagnosis 11 (28%) patients had elevated albumin excretion rates and 10 of these had elevated transferrin excretion rates. After 6 weeks treatment only six (15%) had elevated albumin excretion rates and by 12 weeks this number had fallen to four (10%). NAG and A1M levels also fell with treatment of
diabetes
. There were correlations between the transferrin excretion rate and albumin excretion rate (r = 0.86, P less than 0.0001), transferrin excretion rate and NAG (r = 0.46, P less than 0.0001), and transferrin excretion rate and A1M (r = 0.55, P less than 0.0001) at each visit. There were weaker correlations between the albumin excretion rate and A1M and NAG at each visit. The correlations between the transferrin excretion rate and markers of tubular function (NAG and A1M) suggest that tubular dysfunction may play a part in renal loss of transferrin in
diabetes mellitus
. There were no differences in transferrin excretion rates between patients with and without evidence of complications.
...
PMID:Transferrinuria in type 2 diabetes: the effect of glycaemic control. 185 56
The nature of microproteinuria in the early years of insulin-dependent
diabetes
was investigated in a cross sectional study of 80 children with insulin-dependent
diabetes
and 40 normal children. Urinary excretion of three low molecular weight proteins:
alpha-1-microglobulin
, beta-2-microglobulin and kappa light chains was used as an index of proximal renal tubular function. The first urine samples of the morning were collected and excretion of proteins measured was expressed as ratio of protein to creatinine. There was a strong correlation between excretion of
alpha-1-microglobulin
and chi light chains and their excretion was significantly higher in diabetic children indicating decreased proximal tubular reabsorbtion. The excretion of beta-2-microglobulin was found to be an unsatisfactory index of proximal tubular function. Urinary albumin excretion was not significantly raised in diabetic children and did not correlate with urinary
alpha-1-microglobulin
or chi light chain excretion. Glycaemic control might influence proximal tubular function as both urinary glucose concentration and glycosylated haemoglobin showed correlations with urinary
alpha-1-microglobulin
excretion and with urinary chi light chain excretion.
...
PMID:Tubular dysfunction and microalbuminuria in insulin dependent diabetes. 245 77
Smoking may be a risk factor for the development of diabetic nephropathy. Therefore, the urinary excretion of albumin,
alpha-1-microglobulin
, and N-acetyl-BD glucosaminidase was studied in 24 young adult diabetic patients who smoked. None of these patients had urine samples positive for albumin as determined by the Albustix method (i.e., a urinary concentration of albumin of less than 0.5 g in 24 hr). Control groups were nonsmoking diabetic patients (matched for age and duration of
diabetes
) and nondiabetic subjects (smokers and nonsmokers). Expired breath carbon monoxide and the urinary nicotine metabolite cotinine were measured as objective markers of smoking load. No significant differences in concentrations of urinary proteins were found among any of the four groups. Therefore, smoking is not associated with the development of an increased urinary excretion of albumin within the "microalbuminuria" range. However, further studies are required to determine whether smoking is a risk factor for the progression of established microalbuminuria to Albustix positive proteinuria in diabetic patients.
...
PMID:Urinary excretion of albumin, alpha-1-microglobulin, and N-acetyl-B-D-glucosaminidase in relation to smoking habits in diabetic and nondiabetic subjects. 247 55
Although the protein leak of early diabetic nephropathy is said to be purely a glomerular lesion, there is still controversy as to the existence of a tubular component. We have, therefore, assessed the urine of insulin-dependent diabetics for tubular proteinuria as a feature of early diabetic nephropathy. The urine of 25 patients with increased albumin excretion rate was analyzed by sodium dodecyl polyacrylamide gel electrophoresis. One patient showed high molecular weight proteinuria, 2 showed low molecular weight proteinuria and 2 patients showed both low and high molecular weight proteinuria. The urine was also analyzed for 3 tubular proteins by single radial immunodiffusion. No patient showed elevated beta-2-microglobulin, but
alpha-1-microglobulin
(A1M) (corrected for creatinine excretion) was elevated in 3 out of 25 patients including 2 of the 4 patients with a low molecular weight pattern. One of the patients with raised A1M also had raised retinol-binding protein concentration. We conclude that, in early diabetic nephropathy, proteinuria can have a proximal tubular, as well as a glomerular, component.
Diabetes
Res 1986 May
PMID:Low molecular weight proteinuria in insulin-dependent diabetes. 374 42
The effect of lead on five renal-effect parameters was studied in 151 children (i.e., 3-6-y-olds) who resided at different distances from a lead smelter in Baia Mare, Romania. A relationship was found between concentration of lead in blood (mean +/- standard deviation: 342 +/- 224 microgram/l) and the activity of N-acetyl-beta-D-glucosaminidase in urine, as demonstrated by a 14% increase of N-acetyl-beta-D-glucosaminidase per 100 micrograms/l blood lead that was indicative of renal tubular damage. No relationship was found between blood lead level and the renal-effect parameters albumin,
alpha-1-microglobulin
, retinol binding protein, or alanine aminopeptidase in urine. Cadmium in blood was not elevated. It is well known that N-acetyl-beta-D-glucosaminidase is a sensitive parameter for renal effects, resulting from lead exposure in adults and from
diabetes
and nephrotoxic medicines in children. This study is the first to demonstrate an effect of environmental lead exposure on renal integrity in children.
...
PMID:Environmental lead and renal effects in children. 901 27
The objective of the present study was to assess the relationship between microalbuminuria (Malb) and left ventricular hypertrophy (LVH), when levels of ambulatory BP was token in to account as a confounder factor. Patients with essential hypertension, aged 25 to 50 years old, never treated with antihypertensive drugs, were included in the study. The inclusion criteria were: (a) absence of
diabetes
, renal disease or urinary tract infection; (b) urinary albumin excretion (UAE) estimated in urine of 24 hours in two separate days; (c) echocardiography suitable for measurement of left ventricular mass (LVM); and (d) good quality ambulatory blood pressure monitoring during 24 hours. UAE was measured using a immunonephelometric assay (Behring Institute) and Malb was considered when UAE 30 to 300 mg/24 hours during the two days. LVM was calculated by the Devereaux formula and referred to height (LVMI g/m).
AMBP
was performed using an oscilometric device (Spacelabs 90202 or 90207) during a regular working day. Readings were programmed every 20 minutes between 6 a.m. to midnight and thereafter every 30 minutes. The average BP during a 24 hour period was calculated. One hundred and fifty one patients (96 male, mean age 37 +/- 8 years, body mass index 27.7 +/- 3.7 g/m2) were included. The average values of office BP was 148 +/- 15/96 +/- 8 mm Hg, and the average BP during 24 hours was 137 +/- 13/88 +/- 12 mm Hg. UAE was 30.1 +/- 52.3 mg/24 hr and the LVMI 140.6 +/- 44.1 g/m. The percentage of Malb patients was 28% and those with LVH 34%. A significant relationship between UAE and office and ambulatory SBP and DBP was observed. LVMI was also significantly related to ambulatory SBP and DBP, a relationship that was not found for office BP. In a multiple regression model, significant relationship between UAE and LVMI emerged, independent of diastolic ambulatory BP, age and sex (P < 0.04). In conclusion; we observed a significant relationship between UAE and LVMI, in part, independent of blood pressure. The fact that Malb is associated with the presence of LVH, supports the idea that Malb is a risk marker in essential hypertensive patients.
...
PMID:Microalbuminuria, left ventricular mass and ambulatory blood pressure in essential hypertension. 874 18
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