Micro-albuminuria and large vessel disease in diabetes.
BACKGROUND
Atherosclerosis is a major cause of morbidity and mortality in insulin-dependent diabetes mellitus. Recent studies have shown that albuminuria is a predictor of cardiovascular disease in these patients and there is a particularly high incidence of coronary heart disease in the early stages of albuminuria.
A number of established cardiovascular risk factors, such as elevated blood pressure, atherogenic changes in the plasma concentrations of lipids and lipoproteins, elevated plasma levels of fibrinogen and, probably, hyper-reactivity of platelets are present in patients with diabetic nephropathy. Further, albuminuria may be a marker of generalized disease in the vascular wall of small and large blood vessels. Findings of an elevated rate of transcapillary albumin escape, an elevated plasma concentration of von Willebrand's factor and impaired fibrinolytic capacity in early diabetic nephropathy support this hypothesis.


CONCLUSIONS
The initial pathophysiological mechanisms involved in diabetic nephropathy are still hypothetical and largely unknown.
Jensen
T
T
Steno Memorial Hospital, Gentofte, Denmark.
D000419:Albuminuria / Q000453:epidemiology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000453:epidemiology* / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D004041:Dietary Fats / Q000008:administration & dosage; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors
D000959:Antihypertensive Agents; D004041:Dietary Fats; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors