Increased albumin excretion rate during a standardized exercise-test in diabetics with lowered blood filterability.
Albumin excretion rate in urine is a marker of early, reversible stages of diabetic nephropathy. Does abnormal blood rheology represent an additional risk factor in this multifactorial process? We investigated a possible link between red cell filterability and microalbuminuria during an exercise test (exercise is supposed to improve the detection of excessive microalbuminuria). 77 diabetics (27 females, 50 males, age: 15-60 yr) underwent a 20 min inframaximal progressively increasing workload on cycloergometer, rising heart rate up to 200 minus the age. Filterability of whole blood and washed red cells were measured on 5 microns polycarbonate sieves reused after ultrasonic cleaning. Whole blood filterability was found to be impaired in 35 subjects (group A) and normal in 41 (group B). Groups A and B were matched for age, sex, blood pressure, glycemic equilibrium, and duration of disease. Microalbuminuria was higher in A at rest (39.79 +/- 13.83 micrograms/min vs 12.9 +/- 3.21, p less than 0.01) and after exercise (91.80 +/- 20.79 vs 42.23 +/- 7.85, p less than 0.01). The slopes of regression lines between resting Microalbuminuria and blood pressure were greater in group A than in group B (p less than 0.01). No relationship between microalbuminuria and washed red cell filterability was detected. This study confirms on a larger scale a previous report of our team. Some hemorheologic disorders detectable with whole blood filterability (but not with washed red cell filtration) are associated with an increase in resting and postexercise microalbuminuria.
Orsetti
A
A
Service d'Exploration Physiologique des Hormones et des Métabolismes, Hôpital Lapeyronie, Montpellier.
Brun
J F
JF
Fedou
C
C
Brunel
B
B
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000097:blood / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000652:urine*; D004907:Erythrocyte Deformability; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged