1型糖尿病における尿中ポリオール代謝産物と尿中IV型コラーゲン排泄  [in Japanese] Correlation between Urinary Excretion of Polyol Products and Type IV Collagen in Japanese Type 1 Diabetic Patients  [in Japanese]

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Abstract

ポリオール代謝の元進は糖尿病慢性合併症の一因と考えられている. 早朝尿アルブミン/クレアチニン比 (以下ACR) 100mg/ g.Cr未満の1型糖尿病患者153名を対象とし, 尿中ポリオール代謝産物と糖尿病網膜症, 腎症との関連を検討した, 網膜症がある群では尿中フルクトースとミオイノシトールが有意に高値であった. IV型コラーゲンは高血糖により腎臓で産生され, 腎症の進行と共に尿中に排泄され, ミオイノシトールは尿細管で糖との競合阻害, または腎臓由来に尿中に排泄されるが, 本研究では尿糖とは独立して尿中ミオイノシトールは尿中IV型コラーゲン/クレアチニン比 (以下U-IV-C) と正相関した. 尿ミオイノシトール増加は高血糖によるポリオール代謝経路の元進を反映している可能性があり, U-IV-Cが上昇時尿ミオイノシトールも同時に測定すると糖代謝異常による微細な腎障害を予測できると考察された.

Poor glycemic control greatly influences the development of diabetic complications, and acceleration of the polyol pathway is one of the main factors causing microangiopathy. We clarified whether the urinary excretion of polyol products was related to clinical severity of diabetic complications in 153 type 1 diabetic patients whose urinary albumin creatinine ratio (ACR) was under 100 meg. Cr. Optic fundi were checked by ophthalmologists and ACR, type IV collagen creatinine ratio (U-IV-C), and urinary polyol products such as sorbitol, fructose, and myo-inositol were measured by using a single-void first morning urine. Patients with retinopathy excrete more fructose and myo-inositol greater than those without retinopathy. ACR showed no relationship with urinary polyol products. Urinary type IV collagen independently showed a positive correlation to urinary myo-inositol. Production of type IV collagen was accelerated by high glucose, thought to indicate expansion of the mesangium. Increased urinary myo-inositol may reflect activation of the polyol pathway in the diabetic kidney. Measurement of both urinary myo-inositol and U-IV-C is important in ascertainig the existence of renal impairment caused by high glucose.

Journal

  • Journal of the Japan Diabetes Society

    Journal of the Japan Diabetes Society 45(3), 173-180, 2002-03-30

    THE JAPAN DIABETES SOCIETY

References:  42

Codes

  • NII Article ID (NAID)
    10008362654
  • NII NACSIS-CAT ID (NCID)
    AN00166576
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    0021437X
  • NDL Article ID
    025094714
  • NDL Call No.
    Z19-401
  • Data Source
    CJP  NDL  J-STAGE 
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