Glomerular function and microalbuminuria in children with insulin-dependent diabetes

Renal function has been evaluated in 45 diabetic children (age 12.5±4 years) with a mean diabetes duration of 4.9±3.5 years. Glomerular filtration rate (GFR; inulin and creatinine clearances), renal plasma flow (RPF; PAH clearance), resting urinary albumin excretion (UAE) were measured and compared with indexes of metabolic control: Hb A₁C and blood glucose values (mean, post-prandial and maximal excursion) on the same day. GFR (inulin clearance) and RPF were significantly increased in the diabetic group (171±31 and 778±172 ml/min per 1.73 m²) compared with controls (124±18 and 631±128 ml/min per 1.73 m²). Both parameters were strongly correlated (r=0.73;P<0.001). Creatinine clearance was not correlated to inulin clearance. Hyperfiltration (inulin clearance above 160 ml/min per 1.73 m²) was noted in 61% of the patients and was independent of diabetes duration. Five diabetic children had a UAE level above 15 g/min. No relationship could be established between UAE and any of the metabolic indexes; GFR was weakly correlated to HbA₁C (r=0.35;P<0.05), to mean (r=0.35;P<0.05) and post-prandial blood glucose (r=0.37;P<0.05). In contrast, there was a strong correlation between GFR and the maximal blood excursion (r=0.62;P<0.001). The study shows that renal abnormalities can be detected with a high frequency in diabetic subjects characterized by both an early onset and a short duration of diabetes and suggests the need for a more systematic evaluation of renal parameters in this population.     

2型糖尿病尿5种蛋白联合检测的临床意义

目的 :了解 2型糖尿病尿 5种蛋白变化的临床意义。方法 :对 2 0 4例 2型糖尿病患者和 44例正常对照者(C组 )同时进行 2 4h尿Alb、Trf、IgG、RBP、NAG(分别简称UAE、UTE、UIE、URBPE及UNAGE)、尿糖排泄 (UGE)和肌酐清除率 (Ccr)的检测。根据 2 4hUAE分为 3组 :正常白蛋白尿组 (Ⅰ组 ) ;微量白蛋白尿组 (Ⅱ组 )及大量白蛋白尿组(Ⅲ组 )。结果 :(1) 2 0 4例中 ,微量和大量白蛋白尿发生率为 41 2 %和 7 8% ,与C组相比 ,Ⅱ组Ccr略降低 (P >0 0 5 ) ,Ⅲ组Ccr明显降低 (P <0 0 5 ) ;(2 )UTE在 3组患者中均与UAE呈显著相关 ;UIE在Ⅲ组与UAE明显相关 ;UNAGE在Ⅱ组与UAE明显相关 ;(3)URBPE增高的发生率在Ⅰ组、Ⅱ组和Ⅲ组分别为 11 5 %、42 9%和 75 %。结论 :不同分子量尿多种蛋白联合检测对糖尿病肾脏病变的早期发现和定位有较大的价值     

复方保和丸治疗糖尿病胃轻瘫的疗效

目的 了解复方保和丸对糖尿病胃轻瘫的疗效。方法 治疗组40例,并设西药治病组32例予以对照。结果 治疗组的症状、血脂、胃电图在治疗前后都有显差异,而对照组则无显差异。结论 应用复方保和丸临床疗效明显,没有副作用。     

尿白蛋白排泄率对糖尿病肾病的早期诊断意义

尿白蛋白排泄率对糖尿病肾病的早期诊断意义。方法：８６例糖尿病患者留取过夜１２ｈ尿,用放免法测定白蛋白的含量。结果：病程５年以下组测得ＵＡＥ值产高８例占１８．２％。５年以上组有１８例,升高占４２．９％。     

益肾糖泰颗粒对糖尿病大鼠肾脏病变的影响

目的：探索纯中药制剂益肾糖泰颗粒对糖尿病肾病（ＤＮ）的治疗机理。方法：观察治疗１周、１３周、２６周时益肾糖颗粒对糖尿病肾病大鼠模型的血糖、糖基化血红蛋白、肾重／体重、肾功及肾小球形态变化等。结果：益肾糖泰颗粒有有效改善实验性ＤＮ大鼠异常升高的血糖、ＨｂＡ１ｃ水平,能有效控制糖尿病肾脏的肥大,明显改善实验性ＤＮ大鼠肾脏功能的异常,光镜、电镜和计算机图像分析证实益肾糖泰颗粒能明显改善肾小球组织形态的异     

血浆内皮素和非酯化脂肪酸改变与糖尿病视网膜病变的关系

目的：为探讨血浆内皮素（ＥＴ）和非酯化脂肪酸（ＮＥＦＡ）水平与糖尿病视网膜病变（ＤＲ）Ｒ 关系。方法：分组分析了５６例伴和不伴ＤＲ的２型糖尿病（ＤＭ）人血浆ＥＴ和ＮＥＥＡ水平,并与正常人进行了比较。结果：２型ＤＭ病人血浆ＥＴ水平明显高于正常人,伴有ＤＲ组病人又明显高于无ＤＲ的病人。     

山药对糖尿病小鼠组织丙二醛含量的影响

目的：观察山药对糖尿病小鼠组织丙二醛（ ＭＤＡ） 含量的影响。方法：采用四氧嘧啶制作糖尿病小鼠模型,并以优降糖作阳性对照,连续２１ 天用不同剂量山药灌胃治疗,比较各组心脏、肝脏、肾脏和胰脏过氧化脂质的终末代谢产物ＭＤＡ 含量。结果：①对照组四器官ＭＤＡ显著高于正常组（Ｐ＜ ０ ．０１ 或Ｐ＜ ０ ．００１） ;②剂量在６ ．００ｇ／ｋｇ·ｄ－ １ 以上山药各治疗组四器官ＭＤＡ显著低于对照组（Ｐ＜ ０ ．０５ 或Ｐ＜ ０．００１） ;③与优降糖组比,除肝脏ＭＤＡ 较高外（Ｐ＜ ０．００１） ,中、大剂量山药组心、胰、肾组织ＭＤＡ 较低（Ｐ＜ ０ ．０５ 或Ｐ＜ ０ ．００１） 。结论：山药能明显降低糖尿病小鼠组织内过氧化脂质含量,尤其对心组织作用最强,其次为胰、肾和肝组织,而优降糖对胰组织过氧化脂质无明显影响。     

The pyridoindole antioxidant stobadine inhibited glycation-induced absorbance and fluorescence changes in albumin

We studied the effect of the pyridoindole antioxidant stobadine on glycation-induced absorbance and fluorescence changes in bovine serum albumin (BSA), used as a model protein. Incubation of BSA (4 mg/ml) with glucose (100–400 mM) in 0.12 M phosphate buffer, pH 7.4, in the presence of 100 M Cu²⁺ at 37°C resulted in a time-dependent increase of absorbance (320 nm) and fluorescence (excitation 350 nm, emission 415 nm). The process was found to be dependent on the presence of oxygen and transition metal ions, but equimolar iron could not fully substitute for the activity of copper. The glucose-induced chromo- and fluorophore formation was reduced significantly by stobadine. For 200 mM glucose, in 7- and 14-day incubations, 51%–60% inhibition was obtained at a stobadine concentration of 0.1 mM, and the effect leveled off at higher concentrations of the drug. No inhibition was observed withN-acetyl stobadine, a derivative with restricted antioxidant activity. Since stobadine did not affect the Amadori product formation determined by the thiobarbituric acid (TBA) method as 5-hydroxymethyl furfural (5-HMF) released in boiling oxalic acid, the inhibitory action of stobadine may be explained by its interference with metal-catalyzed oxidation reactions following after the glycation step. The results obtained suggest that antioxidant therapy could be used to limit the damage from adverse glycation-induced processes in diabetes mellitus.     

The natural history of somatosensory and autonomic nerve dysfunction in relation to glycaemic control during the first 5 years after diagnosis of Type 1 (insulin-dependent) diabetes mellitus

Summary The natural evolution of neural dysfunction was studied prospectively over 5 years following diagnosis of Type 1 (insulin-dependent) diabetes in 32 patients aged 12–36 years. Motor and sensory nerve conduction velocities, heart rate variation at rest and during deep breathing, and pupillary function were measured at diagnosis and after 3,12, 24,48, and 60 months. Thermal and vibration sensation thresholds were determined after 24, 48, and 60 months of diabetes. Mean HbA₁ levels of months 3–60 within the normal range of <8.3% (7.3±0.2%) were observed in 13 patients (Group 1), while a mean HbA₁ of months 3–608.3% (10.0±0.3%) was found in 19 patients (Group 2). Mean nerve conduction was significantly diminished in Group 2 as compared with Group 1 in at least 4 out of 6 nerves tested during months 12–60 (p<0.05). Both tests of heart rate variation were significantly impaired in Group 2 as compared with Group 1 after 24 and 60 months (p<0.05), but no differences in pupillary function were observed between the groups. Thermal discrimination but not vibration perception thresholds on the foot were significantly higher in Group 2 than in Group 1 at 40 and 60 months (p<0.05). Abnormalities in nerve conduction, thermal discrimination, and heart rate variation, but not vibration perception threshold and the pupillary function tests were significantly more frequent in Group 2 than in Group 1 at 60 months (p<0.05). After 60 months, none of the patients of Group 1, but 6 and 4 patients of Group 2 developed subclinical or symptomatic neuropathy, respectively (p<0.05). These findings suggest that the evolution of subclinical and symptomatic neuropathy during the first 5 years after diagnosis of Type 1 diabetes may be predicted by poor glycaemic control and prevented by near-normoglycaemia.