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ID 37891
file
creator
Banu, Nazifa
Hara, Hitoshi
Egusa, Genshi
Yamakido, Michio
subject
Type IV collagen
Diabetic nephropathy
Diabetic retinopathy
Non-diabetic renal disease
NDC
Medical sciences
abstract
We investigated the role of measurement of serum and urinary type IV collagen (IV-C) levels in monitoring diabetic microangiopathy. Furthermore, we compared these levels in diabetic nephropathy and non-diabetic renal disease (NDRD). A one-step sandwich enzyme immunoassay was used to measure IV-C levels in 82 diabetic patients, 33 NDRD patients and 20 healthy non-diabetic control subjects. The diabetic patients were classified into four groups according to urinary albumin I creatinine index CACI) (mg/g) and serum creatinine (s-Cr) (mg/dl) : normoalbuminuria (ACI<30), microalbuminuria (ACI 30-300), albuminuria (ACI >300, s-Cr<l.99 mg/dl) and renal insufficiency (s-Cr>l.99 mg/dl). Serum and urinary IV-C levels were significantly elevated even in diabetic patients without clinical evidence of microangiopathy compared with control subjects (p<0.05 and p<0.01, respectively). Both levels were significantly higher in normoalbuminuric patients than in the control subjects, and in patients with microalbuminuria, albuminuria or renal insufficiency than in normoalbuminuric patients, with significant differences between these groups (serum and urinary IV-C, both p<0.0001 by ANOVA). Urinary IV-C and albumin levels were significantly correlated, even in normo- and microalbuminuric patients (r = 0.55, p<0.0001). Serum IV-C in normoalbuminuric patients rose significantly as the degree of retinopathy progressed from background to proliferative stages (p<0.05). Neither serum nor urinary IV-C levels were influenced by glycemic control. Albuminuric diabetic patients (with and without renal insufficiency) had significantly higher levels of serum IV-C compared with those in proteinuric NDRD patients (p<0.005), though there was no significant difference in the urinary IV-C level. However, the urinary IV-CI albumin ratio was significantly higher in albuminuric diabetic patients than in proteinuric NDRD patients, even after adjusting for s-Cr and creatinine clearance (p<0.0001). In conclusion, we suggest that measured serum and urinary IV-C concentrations may serve as new markers for monitoring the development and progression of diabetic microangiopathy, particularly nephropathy. Furthermore, the measurement of serum IV-C concentrations and urinary IV-CI albumin ratios in diabetic patients may allow diabetic nephropathy and non-diabetic renal disease to be differentiated.
description
A part of this work was presented at the 36th annual meeting of the Japan Diabetes Society (Sendai, Japan, May 13-15, 1993), and another part has been accepted for presentation at the 15th International Diabetes Federation Congress (Kobe, Japan, November 6-11, 1994).
journal title
Hiroshima Journal of Medical Sciences
volume
Volume 43
issue
Issue 4
start page
123
end page
133
date of issued
1994-12
publisher
Hiroshima University Medical Press
issn
0018-2052
ncid
language
eng
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
department
Graduate School of Biomedical Science
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