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)

The major cause of disability and early mortality in Type 2 diabetes is cardiovascular disease. An enhanced urinary albumin excretion is strongly predictive of increased mortality, but the causal relationship behind this association is unclear. Abnormalities in the haemostatic system may be involved in the vascular pathology. We therefore studied the level of von Willebrand factor (vWf:Ag), factor VIII (VIII:Ag), fibrinogen, and fibronectin in male diabetic patients 50-70 years of age, with normal albumin excretion (n = 14), microalbuminuria (n = 14), and frank albuminuria (n = 7). Fourteen healthy age-matched males served as a reference group. There were no significant differences between normo- and micro-albuminuric patients but vWf:Ag (p less than 0.01), VIII:Ag (p less than 0.01), and fibrinogen (p less than 0.05) were increased in those with frank albuminuria. Urinary albumin excretion rate was significantly correlated to vWf:Ag (r = 0.46, p = 0.005), VIII:Ag (r = 0.45, p = 0.007), and fibrinogen (r = 0.49, p = 0.003). The known duration of diabetes was correlated to vWf and F VIII. The increased level of vWf:Ag in Type 2 diabetes and the significant association to the urinary albumin excretion rate may suggest a linkage between albuminuria and cardiovascular disease. However, the present study demonstrated no increase in haemostatic variables in patients with microalbuminuria as compared with those with normal albumin excretion.
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PMID:Haemostatic measures in type 2 diabetic patients with microalbuminuria. 214 55

Raised levels of plasma fibronectin (PF), an alpha 2-glycoprotein produced by vascular endothelia, have been previously described in diabetic patients with retinopathy and overt nephropathy. The aim of this study was to investigate whether the presence of microalbuminuria is associated with increased PF concentrations. Twenty Albustix-negative diabetic outpatients with microalbuminuria [median albumin excretion rate (AER): 30.2 micrograms/min; range 12.1-194 micrograms/min] were compared with 58 sex- and age-matched patients without microalbuminuria (median AER 3.1 micrograms/min; range 0.8-12 micrograms/min) and 34 control subjects (median AER 2.8 micrograms/min; range 0.8-12.1 micrograms/min). Mean PF was significantly higher in the group with microalbuminuria (406.7 +/- 85.5 micrograms/ml) than in the group without it (325.3 +/- 76.5 micrograms/ml or in control subjects (334.5 +/- 76 micrograms/ml; P less than .05). PF increase associated with microalbuminuria was independent of the presence of retinopathy. Furthermore, in the whole group of diabetic patients, PF was significantly correlated with AER (r = .33; P = .003). Such correlation also remained significant (P = .0002) after covariance analysis by a stepwise discriminant procedure taking into account age, duration of disease, sex, blood pressure, body weight, therapy, and HbA1. In conclusion, PF increase is associated with microalbuminuria independent of the other considered variables; its role as a possible marker for early diabetic nephropathy remains to be fully clarified.
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PMID:Increased plasma fibronectin concentration in diabetic patients with microalbuminuria. 320 68

Basement membrane thickening and mesangial expansion characterize the renal involvement in diabetes mellitus and precede any symptoms of renal dysfunction, e.g., albuminuria and changes in glomerular filtration rate. Since the morphological changes can only be diagnosed by biopsy, this study was designed to investigate whether the urinary excretion of renal extracellular matrix proteins might reflect the morphological alterations. To specify the extent of renal involvement in diabetes, the patients, type I as well as type II diabetics, were classified according to their urinary albumin excretion: normal albumin excretion below 30 micrograms/min, microalbuminuria from 30 to 300 micrograms/min, and overt albuminuria above 200 micrograms/min. Laminin, collagen IV, and fibronectin, all intrinsic components of the renal extracellular matrix, were determined in serum and urine by radioimmunoassay or enzyme-linked-immunosorbent-assay, respectively. The results are given as median values (mean). Additionally, the urinary fragment pattern of fibronectin was analysed qualitatively by immunoblotting. Laminin concentrations in serum and in urine did not change in diabetics. Collagen IV decreased in serum of patients with increased albumin excretion (controls: mean = 255 micrograms/l, normoalbuminuric patients: mean = 56 micrograms/l, microalbuminuric patients: mean = 52 micrograms/l, and patients with overt albuminuria: mean = 70 micrograms/l; alpha < 0.01) and increased in urine (controls, normoalbuminuric and microalbuminuric patients: not detectable, patients with overt albuminuria: mean = 5 ng/12 h; apha < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Extracellular matrix proteins as early markers in diabetic nephropathy. 762 93

Although increased plasma fibronectin (PF) levels have been found in diabetic patients with microalbuminuria, there is still controversy about its clinical implication for detecting early diabetic nephropathy. To evaluate the PF concentration as a possible marker for early diabetic nephropathy, three groups of sex-and age-matched patients were studied I) 22 insulin dependent diabetic (IDDM) patients with microalbuminuria (mean age +/- SEM: 23.3 +/- 3.6 years, mean urinary albumin excretion rate (AER) +/- SEM: 47.1 +/- 39.5 micrograms/min); II) 17 IDDM patients with normoalbuminuria (mean age: 23.4 +/- 4.4 years, mean AER: 7.8 +/- 2.1 micrograms/min) and III) 20 healthy control subjects (mean age: 22.6 +/- 4.1 years, mean AER: 6.7 +/- 2.1 micrograms/min). PF and urinary excretion of albumin were measured by an immunoturbidimetric method using commercially available kits (Boehringer Mannheim GMBH FRG, and Miles Lab., UK). The mean PF was significantly higher in the group with microalbuminuria (406.5 +/- 122.9 micrograms/ml) than in the group with normoalbuminuria (295.6 +/- 96.9 micrograms/ml, P < 0.01) or in the control group (299.54 +/- 105.5 micrograms/ml, P < 0.01). A weak positive correlation was found between PF and urinary albumin values (r = 0.35, P < 0.05). There were no significant correlations between PF and the other variables such as age, duration of diabetes, body mass index, arterial blood pressure, fasting blood glucose, fructosamine and HbA1 in the diabetic patients or in the control group. Our results suggest that the PF concentration could be a weak marker for early diabetic nephropathy. We cannot therefore use PF instead of microalbuminuria because there is only a weak correlation between PF and microalbuminuria.
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PMID:Can we use plasma fibronectin levels as a marker for early diabetic nephropathy. 762 76

A series of recent observations have shown raised levels of plasma fibronectin (FN), an alpha 2-glycoprotein produced by vascular endothelia, in diabetic patients with retinopathy and overt nephropathy. However, there are no available data on urinary FN and behavior of its excretion in patients affected by diabetic nephropathy characterized by the presence of microalbuminuria. The main purpose of the present study was to investigate whether the urinary excretion of FN (U-FN) is associated with early diabetic nephropathy and other diabetic complications. Fifty-nine diabetic inpatients classified as type II and 15 age-matched control subjects were included in this study. The amount of U-FN, assessed as microgram/g creatinine/24 h, was significantly greater in the patients as a group (348.1 +/- 48.3), than in the controls (108.6 +/- 22.7, p < 0.01). Although patients with overt proteinuria showed an extremely high level of U-FN (1080.5 +/- 184.0; range 216.1 +/- 1726.8), mean U-FN tended to be higher in the group with microalbuminuria (262.4 +/- 21.9; range 101.9-591.9) than in the group without it (188.1 +/- 34.3; range 19.4 +/- 582.4, p < 0.08). In patients who did not have retinopathy and neuropathy, the U-FN was significantly higher in the group with microalbuminuria (222.5 +/- 28.5) than in the group without it (116.1 +/- 22.6, p < 0.01). A highly significant negative correlation existed between endogenous creatinine clearance values and the amounts of U-FN in the patients (r = -0.642, p < 0.01), while there was no such relationship in the controls (r = 0.167, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Increased urinary fibronectin excretion in type II diabetic patients with microalbuminuria. 766 99

Several methods used in the prediction of hypertensive disorders of pregnancy (HDP) were evaluated with statistical techniques. Only cohort studies were considered. The data reviewed show that platelet count, hematocrit, serum uric acid, and microalbuminuria are poor predictors of HDP. Mean arterial pressure predicts transient hypertension rather than preeclampsia. Fibronectin, urinary calcium excretion, roll-over test, and Doppler ultrasound showed contradictory and nonconclusive findings among the different authors. Isometric exercise test showed high predictive values but only two studies have been performed. Angiotensin II sensitivity was the test that showed the best predictive values but it is useless in clinical practice. In conclusion, currently, there is no test that fulfills all criteria established to be a good predictor of hypertensive disorders of pregnancy. The search for an adequate method for the screening of HDP with a high sensitivity, inexpensive, and easy to perform should still be a priority in future investigations.
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PMID:Evaluation of methods used in the prediction of hypertensive disorders of pregnancy. 816 16

Previous investigations performed in human diabetics demonstrate an increase in their urinary fibronectin excretion which was already present in subjects without microalbuminuria and which was elevated prior to functional restrictions. The present study was performed to examine whether in an experimental model these data obtained in men can be confirmed using an animal experimental model, and to further study pathomechanisms of diabetic nephropathy in rats. Fibronectin levels in serum and urine, and renal functional properties such as creatinine clearance, urinary albumin and protein excretion were studied in rats rendered diabetic with streptozotocin and compared with values of control and insulin treated animals for 5 months. Diabetic animals demonstrated the same creatinine clearance, but slightly decreased albumin and total protein excretion rates compared to controls and insulin "treated", euglycaemic animals. Diabetic rats showed a significantly increased excretion following day 42 compared to controls and insulin "treated" group. Concerning serum fibronectin, there was no significant difference between control, diabetic and insulin "treated" animals. The urinary fragment pattern of fibronectin was analyzed qualitatively by immunoblotting pattern and consisted of two main bands (M(r) 66,000 and 45,000). These bands were not altered in controls, insulin "treated" and diabetic rats, independent of the stage of renal involvement in diabetes. Present data provide evidence that fibronectin excretion is elevated in diabetic animals prior to functional restrictions, confirming results obtained in human diabetics. Therefore, determination of urinary fibronectin can serve as a more sensitive indicator for renal involvement in diabetes mellitus than microalbuminuria or changes in glomerular filtration rate. Urinary excretion may therefore serve as an early marker for the renal involvement in diabetes before the onset of clinical symptoms.
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PMID:Urinary fibronectin excretion in streptozotocin-diabetic rats. 883 Oct 50

A 15-year clinical follow-up is reported for a familial glomerulopathy characterized on light microscopy by the glomerular deposition of giant fibrillary deposits (Virchows Arch A Pathol Anat Histol 388:313-326, 1980). On electron microscopy, the deposits consist of randomly oriented fibrils (12 to 16 nm in width and 120 to 170 nm in length). These deposits show positive immunoreactivity for fibronectin. One hundred fifty-seven of 197 family members within five generations were investigated. The disease is characterized by the occurrence of albuminuria in the third to fourth decades of life and slow progression to end-stage renal disease over a period of 15 to 20 years with the occurrence of generalized distal tubular acidosis (renal tubular acidosis type IV), hypertension, and the nephrotic syndrome. The frequent occurrence of otherwise unexplained microalbuminuria in young individuals of generations IV and V could be indicative of incipient glomerular disease. In one affected male individual and in his unaffected sister, renal cell carcinoma was diagnosed, raising the possibility that this familial glomerulopathy might be associated with an increased risk to develop renal cell cancer by direct or indirect (associated genetic predisposition) mechanisms. The disease relapsed in one renal transplant, raising the possibility of the presence of a transferable factor that could be part of the deposited fibrillar material or, alternatively, interfere with the glomerular handling of the deposited material.
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PMID:Familial glomerulopathy with giant fibrillar (fibronectin-positive) deposits: 15-year follow-up in a large kindred. 915 3

Oxidative stress has been proposed as the basis for the pathogenesis of diabetic nephropathy. Rebamipide is a novel antiulcer drug that has, in addition, oxygen radical scavenging activity. Our study examines whether rebamipide could ameliorate the pathophysiology associated with experimental diabetes in vivo, such as microalbuminuria, and to reverse the increased production of transforming growth factor-beta1 and fibronectin in SV-40 transformed murine mesangial cells in culture that were stimulated with high glucose. Chronic administration of rebamipide (100 mg/kg/day, p.o., for 3 wk) to rats, in which diabetes was previously induced by the i.v. injection of streptozotocin 50 mg/kg, reversed hyperglycemia, which would contribute to prevent the increases in urinary excretion rates of albumin and lipid peroxides observed in this experimental model. Rebamipide, at this dose level, did not cause any discernible effect on age-matched control rats. Rebamipide 2 mM was as effective as 20 mM of dimethylthiourea, a known hydroxyl radical scavenger, in inhibiting the increase in lipid peroxides, transforming growth factor-beta1, fibronectin mRNAs and proteins induced by incubation of cultured mesangial cells with high glucose. Our data suggest that rebamipide attenuates high glucose-induced nephropathy, which is attributable, in part, to its antioxidative property and, in part, to its effect on reversing hyperglycemia.
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PMID:Effects of rebamipide in a model of experimental diabetes and on the synthesis of transforming growth factor-beta and fibronectin, and lipid peroxidation induced by high glucose in cultured mesangial cells. 919 Aug 83

A group of 32 selected hypertensive pregnant women under antihypertensive therapy, with biochemical parameters, functional parameters, plasma fibronectin levels (PLF), microalbuminuria (MA) levels and continuous 24 h blood pressure monitoring, were followed monthly until delivery and during puerperium. Also possible biochemical and clinical markers and the predictive value in the complications during PIH were attempted to be identified. There was a statistical correlation between systolic pressure peaks associated with high levels of PLF and MA in hypertensive pregnant women who may have a higher risk of pregnancy or cardiovascular complications. Continuous 24 h blood pressure monitoring in hypertensive pregnancies was found to be helpful in identifying the highest risk patients especially by reading the night peak percentages.
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PMID:Blood pressure peaks correlated with plasma fibronectin levels and microalbuminuria in hypertensive pregnancies. 934 69


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