title: A longitudinal evaluation of urinary glycosaminoglycan excretion in normoalbuminuric type 1 diabetic patients.
abstract: BACKGROUND
  Previously, we found high urinary glycosaminoglycan (GAG) concentration, together with an altered electrophoretic pattern, in normoalbuminuric type 1 diabetic subjects with hemoglobin A(1c) (HbA(1c)) > or =8.0%. The purpose of this study was long-term evaluation of GAG excretion variations in these patients compared to those with HbA(1c) < 8.0% at baseline who maintained better metabolic control over time.
  
  
  METHODS
  We enrolled 26 normotensive, normoalbuminuric type 1 diabetic patients and divided them into two groups according to mean HbA(1c) levels during the follow-up period. GAGs were isolated from 24-h urine samples on two separate occasions, at baseline and after a mean (+/-SD) follow-up of 6.8+/-1.1 years.
  
  
  RESULTS
  All patients remained normoalbuminuric at follow-up, and had normal urinary alpha(1)-microglobulin levels. In patients with HbA(1c) <8.0%, total GAG levels and low sulfated chondroitin sulfate-proteoglycan/chondroitin sulfate ratio were almost unchanged during the follow-up period. In contrast, these increased in patients with HbA(1c) > or =8.0% and were significantly related to both HbA(1c) levels and the duration of poor glycemic control.
  
  
  CONCLUSIONS
  Our results show a strong influence of hyperglycemic environment on GAG metabolism in diabetes and indicate that the distribution pattern of urinary GAGs, besides their total concentration, may be predictive of altered GAG metabolism in type 1 diabetes.
authors: Department of Physiological, Biochemical and Cellular Science, University of Sassari, via Muroni 25, 07100 Sassari, Italy. demuro@uniss.it
authors: Pierina
authors: P
authors: De Muro
authors: Pietro
authors: P
authors: Fresu
authors: Giancarlo
authors: G
authors: Tonolo
authors: Mario
authors: M
authors: Maioli
authors: Giovanni Battista
authors: GB
authors: Cherchi
authors: Antonio
authors: A
authors: Murgia
authors: Cristina
authors: C
authors: Ibba
authors: Giovanni Maria
authors: GM
authors: Sanna
authors: Gian Mario
authors: GM
authors: Cherchi