<原著>糖尿病性腎症における尿中微量アルブミンおよび免疫グロブリンの臨床的意義
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概要
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To study the clinical significance of the correlation between urinary albumin and urinary IgG in diabetics, 24 hour urinary excretion of albumin and IgG were measured in 113 patients of non-insulin dependent diabetes mellitus, 72 patients of glomerulonephritis, and 20 healthy subjects by immunoturbidimetric method (ITM). The amounts of urinary IgG were 3.97±3.24mg/day in healthy subjects, 5.52±5.98mg/day in diabetics with normoalbuminuria (urinary albumin excretion, less than 15mg/day), 21.60±31.61mg/day in those with microalbuminuria (more than 30mg/day), and 384.6±647.0mg/day in those with macroalbbuminuria (more than 300mg/day). A significantly higher level of urinary IgG was observed in diabetics with micro-and macroalbuminuria compared to healthy subjects and to diabetics with normoalbuminuria. Urinary IgG excretion wa scorrelated weakly with urinary albumin excretion in diabetics with normo and microalbuminuria (r=0.489,p<0.01). There was a stronger correlation between them in those with macroalbuminuria (r=0.897,p<0.001). Urinary albumin/IgG ratio showed a significantly higher level in diabetics compared with patients of glomerulonephritis in the groups with microalbuminuria. In patients with macroalbuminuria, there was no significant difference between patients of diabetes and glomerulonephritis. Urinary albumin excretion was increased significantly during a 1-3 year-observation period in diabetics with poor control state of blood sugar, hypertension, long-term duration or retinopathy. Urinary IgG excretion was increased significantly in diabetics with retinopathy during the same period. In diabetics who showed an increased albumin in the urine after a 1-3 year-observation period, urinary IgG excretion increased significantly (p<0.05). Diabetics with both microalbuminuria and microglobulinuria were apt to develop into macroalbuminuria in comparison to those without microglobulinuria. The measurement of urinary IgG associated with albumin determination was concluded to be a useful marker of renal impairment in diabetics.
- 近畿大学の論文
- 1991-06-25