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)

Diabetes mellitus is a major cause of peripheral neuropathy, commonly manifested as distal symmetrical polyneuropathy. This review examines evidence for the importance of vascular factors and their metabolic substrate from human and animal studies. Diabetic neuropathy is associated with risk factors for macrovascular disease and with other microvascular complications such as poor metabolic control, dyslipidaemia, body mass index, smoking, microalbuminuria and retinopathy. Studies in human and animal models have shown reduced nerve perfusion and endoneurial hypoxia. Investigations on biopsy material from patients with mild to severe neuropathy show graded structural changes in nerve microvasculature including basement membrane thickening, pericyte degeneration and endothelial cell hyperplasia. Arterio-venous shunting also contributes to reduced endoneurial perfusion. These vascular changes strongly correlate with clinical defects and nerve pathology. Vasodilator treatment in patients and animals improves nerve function. Early vasa nervorum functional changes are caused by the metabolic insults of diabetes, the balance between vasodilation and vasoconstriction is altered. Vascular endothelium is particularly vulnerable, with deficits in the major endothelial vasodilators, nitric oxide, endothelium-derived hyperpolarising factor and prostacyclin. Hyperglycaemia and dyslipidaemia driven oxidative stress is a major contributor, enhanced by advanced glycation end product formation and polyol pathway activation. These are coupled to protein kinase C activation and omega-6 essential fatty acid dysmetabolism. Together, this complex of interacting metabolic factors accounts for endothelial dysfunction, reduced nerve perfusion and function. Thus, the evidence emphasises the importance of vascular dysfunction, driven by metabolic change, as a cause of diabetic neuropathy, and highlights potential therapeutic approaches.
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PMID:Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy. 1171 28

The aim of the study was to evaluate the incidence of diabetic neuropathy. The examined group consisted of 32 patients (14 boys, 18 girls) 16 to 19 years old with diabetes duration of 5 till 17 years, treated actually with multiple injections of human insulin. Diabetic neuropathy was observed in 56% of patients. The incidence of neuropathy was higher after 15 years of diabetes duration, in patients with bad metabolic control - HbA1c>8%, multiple ketoacidosis (p=0.003) and higher total cholesterol levels (p=0.003), with microalbuminuria (64.3%) and macroalbuminuria (83.3%) and in patients with systolic and diastolic blood pressure equal and/or above 90 % percentyle.
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PMID:[The incidence of neuropathy in patients with diabetes type 1]. 1281 69