title: Influence of glycemic control and hypertension on urinary microprotein excretion in non-insulin-dependent diabetes mellitus.
abstract: In order to evaluate the influence of glycemic control and hypertension on the development of diabetic nephropathy, we measured urinary excretion of albumin (AER) and other microproteins in non-insulin-dependent diabetes mellitus (NIDDM), and reexamined the 103 patients who had had AER less than 300 micrograms/min at the initial study 12-18 months later. AER in the patients with HbA1c greater than or equal to 7.5% increased significantly in both the normoalbuminuric (AER less than 30 micrograms/min) and microalbuminuric (30-300 micrograms/min) groups, whereas no significant change in AER was observed in the patients with HbA1c less than 7.5%. In the microalbuminuric group, AER in both hypertensive and normotensive patients increased significantly. In this group, the change in AER correlated positively with the change in alpha 1-microglobulin (alpha 1M). These results indicate that glycemic control has a greater influence on the development of nephropathy in its early stage than hypertension and that alpha 1M is as a good predictor of nephropathy as albumin.
authors.affiliation: Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Wainai
authors.forename: F
authors.initials: F
authors.lastname: Katsukawa
authors.forename: I
authors.initials: I
authors.lastname: Takei
authors.forename: H
authors.initials: H
authors.lastname: Maruyama
authors.forename: K
authors.initials: K
authors.lastname: Kataoka
authors.forename: T
authors.initials: T
authors.lastname: Saruta
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000419:Albuminuria; D000510:Alpha-Globulins / Q000652:urine; D015415:Biomarkers / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D011480:Protease Inhibitors / Q000652:urine; D011507:Proteinuria; D001613:beta 2-Microglobulin / Q000652:urine
chemical_list: D000118:Acetylglucosaminidase; D000510:Alpha-Globulins; D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D011480:Protease Inhibitors; D001613:beta 2-Microglobulin; C016001:alpha-1-microglobulin