von Willebrand factor antigen in plasma and urine in patients with type I (insulin-dependent) diabetes mellitus with and without nephropathy.
von Willebrand factor (vWF) antigens were quantitatively and qualitatively analyzed in plasma and urine in 41 patients with type I (insulin-dependent) diabetes. The patients were divided into three groups according to their albumin excretion: group N (n = 24) without any excretion (less than 20 micrograms/min), group M (n = 8) with microalbuminuria (20-200 micrograms/min), and group P (n = 9) with persistent albuminuria (greater than 200 micrograms/min). Healthy subjects served as controls (n = 28). The plasma concentration of vWF was higher (p less than 0.05) in the patients with diabetes mellitus than in the controls. Differences between the groups of patients were not statistically significant. The typical multimeric structure described for vWF in normal plasma was observed in all patients. In urine, significantly higher excretion of vWF fragments was observed in the three diabetic study groups as compared with the controls. In group P the patients' urinary vWF/creatinine levels tended to be higher than in groups N and M. Qualitative analysis of urinary vWF fragments demonstrated a similar distribution pattern of fragments, with three distinctive peaks, in the patients of groups N and M and in the controls. The distribution pattern of vWF fragments in group P, however, differed clearly from that in the controls and showed a great variation within the group. The urinary fragments tended to be of a higher molecular weight and several less distinct fragments with the whole spectrum of molecular weight were observed. Because in these patients with proteinuria no qualitative changes appeared in plasma, it is suggested that abnormal degradation of vWF occurred in the kidneys.(ABSTRACT TRUNCATED AT 250 WORDS)
Silveira
A M
AM
Department of Blood Coagulation Research, Karolinska Institute, Stockholm, Sweden.
Sjöberg
S
S
Blombäck
M
M
Ostman
J
J
D000328:Adult; D000419:Albuminuria; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D003928:Diabetic Nephropathies / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D003930:Diabetic Retinopathy / Q000097:blood / Q000652:urine; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D012016:Reference Values; D014841:von Willebrand Factor / Q000032:analysis* / Q000652:urine
D015415:Biomarkers; D006442:Glycated Hemoglobin; D014841:von Willebrand Factor