Clustering of albumin excretion rate abnormalities in Caucasian patients with NIDDM |
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| Authors: | P. P. Faronato M. Maioli G. Tonolo E. Brocco F. Noventa F. Piarulli C. Abaterusso F. Modena G. de Bigontina M. Velussi S. Inchiostro F. Santeusanio A. Bueti R. Nosadini |
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| Affiliation: | (1) Diabetic Outpatient Clinics of Feltre, Contarina, Pieve di Cadore, Monfalcone, Este and Pordenone, Italy, IT;(2) Medical Clinic, University of Sassari, Sassari, Italy, IT;(3) Institute of Internal Medicine and Centre of the National Research Council (CNR) for the study of Ageing, University of Padua, Padua, Italy, IT;(4) Institute of Medical and Endocrinological Sciences, University of Perugia, Perugia, Italy, IT |
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| Abstract: | Summary Proteinuria and nephropathy have been found to cluster in families of non-insulin-dependent diabetic (NIDDM) Pima Indian, and in Caucasian insulin-dependent diabetic (IDDM) patients. No information is at present available for Caucasian NIDDM patients. The aim of the present study was to determine whether micro-macroalbuminuria (AER + ) is associated with albumin excretion rate abnormalities in diabetic and non-diabetic siblings of probands with NIDDM and AER + . We identified 169 Caucasian families with one NIDDM proband (the patient with longest known NIDDM duration) (101 families with only NIDDM siblings, 33 families with both NIDDM and non-NIDDM siblings and 35 families with only non-NIDDM siblings). Of the probands 56 had AER + [Prob-NIDDM-(AER + )], 78 had AER– [Prob-NIDDM-(AER–)], 74 siblings of Prob-NIDDM-(AER + ), and 113 siblings of Prob-NIDDM-(AER–) also had NIDDM. Data on albuminuria and retinopathy from multiple sibling pairs when the size of the sibship was more than two was adjusted according to a weighting factor. The odds ratio for AER + , in siblings of Prob-NIDDM-(AER + ) adjusted for age, hypertension, glycated haemoglobin A1 c and other confounding variables was 3.94 (95 % confidence intervals: 1.93–9.01) as compared to siblings of Prob-NIDDM-(AER–). The 74 siblings of Prob-NIDDM-(AER + ) had higher prevalence of proliferative retinopathy than siblings of Prob-NIDDM-(AER–) (14 vs 2 %; p < 0.01). We also identified 66 non-diabetic siblings of 41 NIDDM probands with AER + and 36 non-diabetic siblings of 27 NIDDM probands with AER–. Albumin excretion was two times higher, although still within the normal range, in the non-diabetic siblings of Prob-NIDDM-(AER + ) than in siblings of Prob-NIDDM-(AER–) [median = 13.5 (range 0.5–148) vs 6.6 (range 1–17) μg/min (p < 0.05)]. In conclusion higher rates of albumin excretion aggregate in Caucasian families with NIDDM. Proliferative retinopathy is more frequently observed in families showing a clustering of AER + and NIDDM. These findings suggest that familial factors play a role in the pathogenesis of renal and retinal complications in NIDDM. [Diabetologia (1997) 40: 816–823] Received: 6 November 1996 and in revised form: 17 February 1997 |
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| Keywords: | Non-insulin-dependent diabetes mellitus micro-macroalbuminuria familial clustering sib pair analysis diabetic retinopathy. |
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