早期糖尿病性腎症における尿中トランスフェリン測定の意義

概要

論文の詳細を見る
Microalbuminuria has been accepted as a gold standard for the indicator of incipient nephropathy in persons with diabetes mellitus. The purpose of this study was to determine whether microtransferrinuria can be used as an additional marker for early diabetic nephropathy. We measured transferrin, albumin and creatinine concentrations in the first morning urine specimen from 903 persons with non-insulin dependent diabetes mellitus whose serum creatinine concentration was below 2.0 mg/dl. There were significant differences among the geometric mean urine transferrin/creatinine ratios (TCRs) of normo-, micro- and macroalbuminuric diabetic subjects (0.31, 2.15 and 43.06 mg/gCr, respectively). Although urine TCR strongly correlated with urine albumin/creatinine ratio (ACR, r_s=0.9354, p<0.001), TCR was within normal limit in 134 persons (30.0%) among 450 micro- or macro albuminuric diabetic patients. On the other hand, TCR was elevated only in 6 persons (1.3%) among 453 normoalbuminuric subjects. From these results, we conclude that there is little evidence that microtransferrinuria is a more sensitive indicator of early diabetic nephropathy than is micro albuminuria.
1998-05-25