title: Significant association of poor glycemic control with increased resistance in efferent arterioles--study of inulin and para-aminohippuric acid clearance in humans.
abstract: OBJECTIVE
  To examine whether glomerular hemodynamic parameters in humans are associated with glycemic control indices, by simultaneously measuring clearance of inulin (Cin) and para-aminohippuric acid (CPHA).
  
  
  METHODS
  Thirty-one subjects (age 55.4±14.7 years; 15 men and 16 women; 21 diabetics and 10 non-diabetics) were enrolled. Cin and CPAH were measured simultaneously. Afferent arteriolar resistance (Ra), efferent arteriolar resistance (Re), glomerular hydrostatic pressure (Pglo) and glomerular filtration fraction (FF) were calculated according to Gomez' formula.
  
  
  RESULTS
  FF correlated significantly and positively with fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and glycated albumin (GA) (r=0.396, p=0.0303; r=0.587, p=0.0007; r=0.525, p=0.0070, respectively). Pglo correlated significantly and positively with FPG, HbA1c and GA (r=0.572, p=0.0008; r=0.535, p=0.0019; r=0.540, p=0.0053, respectively). Although there was no significant correlation between Ra and glycemic control indices, Re correlated significantly and positively with HbA1c and GA (r=0.499, p=0.0043; r=0.592, p=0.0018, respectively). FF, Pglo and Re were associated significantly with HbA1c and GA after adjustment for age.
  
  
  CONCLUSIONS
  These results demonstrate, in humans, that poor glycemic control is associated with increased Re, but not Ra. It is suggested that increased Re causes increased Pglo, leading to increased FF. Thus, hemodynamic abnormalities with poor glycemic control may be related to glomerular hypertension in humans.
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Tsuda
authors.affiliation: Department of Nephrology, Osaka City University, Graduate School of Medicine, Osaka, Japan. Electronic address: ish@med.osaka-cu.ac.jp.
authors.forename: E
authors.initials: E
authors.lastname: Ishimura
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ichii
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakatani
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Fukumoto
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Emoto
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Inaba
mesh_terms: D000328:Adult; D000368:Aged; D001160:Arterioles / Q000503:physiopathology*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D017127:Glycation End Products, Advanced; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007444:Inulin / Q000097:blood*; D007678:Kidney Glomerulus / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D014655:Vascular Resistance / Q000502:physiology*; D055815:Young Adult; D010130:p-Aminohippuric Acid / Q000097:blood*; D000093423:Glycated Serum Albumin
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007004:Hypoglycemic Agents; D007444:Inulin; D012709:Serum Albumin; D010130:p-Aminohippuric Acid; D000093423:Glycated Serum Albumin
keywords: Clearance; Efferent arteriole; Glomerular hemodynamic; Inulin; Para-aminohippuric acid; Type 2 diabetes