Early changes in glomerular size selectivity in young adults with type 1 diabetes and retinopathy. Results from the Diabetes Incidence Study in Sweden.
OBJECTIVE
To investigate the relationship between early-onset retinopathy and urinary markers of renal dysfunction.


METHODS
The Diabetes Incidence Study in Sweden (DISS) aims to register all new cases of diabetes in young adults (15-34 years). In 1987-1988, 806 patients were reported and later invited to participate in a follow-up study focusing on microvascular complications after approximately 10 years of diabetes. In the present study, 149 patients with type 1 diabetes, completed eye examination, and urine sampling were included.


RESULTS
The patients with retinopathy (n=58, 39%) had higher HbA(1c) (P<.001) and urinary IgG2/creatinine (P<.05) and IgG2/IgG4 ratios (P<.05). Patients with maculopathy had the highest levels. No significant differences in urinary albumin/creatinine, glycosaminoglycans (GAGs)/creatinine, Tamm-Horsfall protein (THP)/creatinine, and IgG4/creatinine ratios were found. Women had higher urinary albumin/creatinine (P<.01) and urinary IgG2/creatinine ratios (P<.01) than men.


CONCLUSIONS
Young adults with type 1 diabetes and early-onset retinopathy had higher IgG2/creatinine and IgG2/IgG4 ratios than patients without retinopathy indicating that retinopathy is associated with a change in glomerular size selectivity. This was found in association with normal urinary albumin and THP excretion and may be suspected to reflect early general vascular changes.
Torffvit
Ole
O
Department of Medicine, University Hospital of Lund, Lund University, S-221 85 Lund, Sweden. ole.torffvit@med.lu.se
Eriksson
Jan W
JW
Henricsson
Marianne
M
Sundkvist
Göran
G
Arnqvist
Hans J
HJ
Blohmé
Göran
G
Bolinder
Jan
J
Nyström
Lennarth
L
Ostman
Jan
J
Svensson
Maria
M
D000328:Adult; D015415:Biomarkers / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology* / Q000473:pathology* / Q000652:urine; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology* / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000652:urine; D008297:Male; D013548:Sweden / Q000453:epidemiology
D015415:Biomarkers