[Hypertensive type I diabetics have a higher level of microalbuminuria than normotensives irrespective of blood glucose equilibrium].
Micro-albuminuria, glycosylated haemoglobin and creatinine clearance were measured in 28 insulin dependent and 8 insulin requiring diabetic patients (17 males aged 45 +/- 14.4 and 19 females aged 40 +/- 17 years). Twelve had retinopathy and six had high blood pressure. There was no statistical difference of duration of diabetes, creatinine clearance and glycosylated haemoglobin between patients with normal microalbuminuria and patients with hyper microalbuminuria. There was no correlation between glycosylated haemoglobin and micro-albuminuria, between creatinine clearance and micro-albuminuria, and between creatinine clearance and glycosylated haemoglobin. Patients with retinopathy did not have significantly higher levels of micro-albuminuria. Hypertensive patients had a significantly higher micro-albuminuria (p = 0.03, m = 45.10 +/- 56) compared with normotensive patients (m = 15.49 +/- 17.54). Glycosylated haemoglobin did not differ whether patients were normo or hypertensive. Hypertensive patients were significantly older (p = 0.01) than normotensive. The lack of difference in glycemic control between normo and hypertensive diabetics suggests that diabetes and hypertension are two independent cumulative risk factors of micro-albuminuria. Hypermicro-albuminuria may be secondary to microangiopathy in young diabetics and secondary to hypertension in old diabetics.
Verger
M F
MF
Service de médecine interne et néphrologie, Centre hospitalier René Dubos, Pontoise.
Larpent
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D003401:Creatine / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003925:Diabetic Angiopathies / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000097:blood*; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D003401:Creatine; D006442:Glycated Hemoglobin
Les diabétiques type I hypertendus ont une microalbuminurie plus élevée que les normotendus indépendamment de l'équilibre glycémique.