Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0730345 (microalbuminuria)
 4,018 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One-hundred and seventy-two normotensive, insulin-dependent diabetic patients without clinical proteinuria (Albustix negative) were typed for the major histocompatibility complex class I (HLA-A, -B) and class II (HLA-DR) antigens. Urinary albumin excretion was measured as the albumin:creatinine ratio (UA/UC, mg/mmol) in an early morning sample. Patients expressing the HLA-A2 antigen had significantly higher UA/UC values than those not expressing the antigen. The observed ratio of geometric means was 1.77 (95 per cent confidence interval (CI) 1.18-2.67; p < 0.01); the relative risk of microalbuminuria (UA/UC > 3.0 mg/mmol) associated with expression of HLA-A2 was 2.52 (95 per cent CI 1.11-5.73; p < 0.05). There was no significant association between UA/UC and HLA-B8, -B15, -DR3, -DR4 or other antigens. Patients were re-studied after a mean period of 5.3 years: multiple linear regression analysis showed that the UA/UC at this time was positively related to the initial glycosylated haemoglobin level (p < 0.01) and expression of the HLA-A2 antigen (p < 0.05), but not to blood pressure or creatinine clearance. Fifteen patients developed macroalbuminuria at follow-up (UA/UC > 45.5 mg/mmol). Compared with a group matched for age, sex, duration of diabetes, and glycosylated haemoglobin who did not develop macroalbuminuria, macroalbuminuric patients had a higher frequency of HLA-A2 (p < 0.01). The odds ratio of progressing to macroalbuminuria associated with HLA-A2 had a 95 per cent CI of 1.71 to infinity. We conclude that an immunogenetic factor may play a role in the development of early diabetic nephropathy and that the risk associated with expression of the HLA-A2 antigen is independent of metabolic control and blood pressure.
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PMID:The immunogenetics of early nephropathy in insulin-dependent diabetes mellitus: association between the HLA-A2 antigen and albuminuria. 144 47

Sixty-four infant diabetics were kept under observation for an average of 6.1 years to obtain ophthalmologic and endocrinologic data (biomicroscopic fundus examination, fundus photography, fluorescein angiography; blood sugar level, HbA1c determination, ketoacidosis, microalbuminuria, HLA-DR typing). In 28 patients (44%, Group B) retinal vascular changes corresponding to the picture of diabetic preretinopathy were detected by fluorescein angiography. In 36 children (56%, Group A), the retinal vascular system was normal. In 16 patients vascular anomalies increased during the observation period, while in 12 patients no further changes were seen. On comparing the endocrinologic findings in the two groups, the only statistically significant difference was in the ketoacidosis values. A tendency to hypoglycemic attacks, as well as elevated HbA1c and microalbuminuria levels, was likewise more frequent in Group B. Aside from the typical distribution, HLA-DR typing revealed a considerable percentage of children with 1/4 localization in Group B only. It was not seen in any patient in Group A. These results give rise to the hope that HLA-DR typing will enable prognostic conclusions to be drawn concerning the time of onset and progression of diabetic retinal alterations in the future.
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PMID:[Long-term ophthalmologic follow-up of diabetic children]. 343 Oct 11

Both metabolic and genetic factors may contribute to the etiology of diabetic nephropathy. We selected 2 different groups of Type I diabetic patients in an attempt to evaluate both factors. HbA1c values and urinary albumin excretion were examined in 114 selected Type I diabetes patients with disease duration of more than 15 yr. We found signs of late renal complications in 28% of these patients. A clear difference in blood glucose control appeared between the 2 groups; the mean HbA1c value during the last 3 yr was 9.5% in the group with microalbuminuria or nephropathy, compared to 8.5% in the normoalbuminuric group (p < 0.0001). With the aim of studying genetic markers alone, we selected a group of 30 Type I diabetes patients with microalbuminuria and a control group of patients without microalbuminuria, but with very similar blood glucose control (e.g. similar mean 1 yr HbA1c values), age and disease duration. All individuals in both patient groups were genomically typed for HLA-DR, -DQ genes and insulin-gene region (INS) polymorphisms. We found no association between HLA class II alleles and microalbuminuria. Neither did we find any association with particular INS polymorphisms. This data indicates that neither genes in the HLA nor in the insulin region are of importance for development of diabetic microalbuminuria. However, all 11 patients with overt nephropathy carried a given INS polymorphism, suggesting an influence of this region for progression to overt nephropathy.
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PMID:Influence of genetic factors (HLA class II genes, insulin-gene region polymorphisms) and metabolic control on the development of diabetic nephropathy. 792 46