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당뇨병환자에서 뇨중 Fibronection 치에 관한 연구
이인규(In Kyu Lee),박근용(Keun Young Park),조성래(Sung Rae Cho),박기락(Ki Rak Park),진선미(Sun Mi Jin),손건영(Kun Young Sohn),이병헌(Bung Heun Lee),조준승(Joon Seung Jo) 대한내과학회 1995 대한내과학회지 Vol.49 No.4
N/A Objectives: In diabetic nephropathy, thickening of basement membrane in the glomerulus and tubule is a well known finding. Therefore, we evaluated whether the excretion of urinary fibronectin, which is one of important factors of basement membrane, is related with the presence of diabetic nephropathy. Methods: We measured and compared the urinary fibronectin excretion rate(FER) and the albumin excretion rate (AER) in 20 healthy controls and 89 diabetic patients', 44patients without microalbuminuria, 26 patients with microalbuminuria, 19 patients with overt nephropathy, Urinary fibronectin levels were measured by our enzyme linked immunosorbent assay (ELISA) method and urinary microalbumin by radioimmunoassay. Results: Patients with overt proteinuria were characterized by a significantly (p<0.005) longer duration of diabetes (Mean±SD: 97.1±30.8 years, 60.5±74.4 years, 62.2±58.3 years) and by a higher systolic presure (l34.2±19,5mmHg, 120.5±5.8 mmHg, 121.8±14.2mmHg, 127.7±14.5mmHg) compared with control and diabetic patients with or with- out microabluminuria 2) The mean fibronectin excretion rate was significantly (p<0,05) higher in the group with microalbuminuria (277.9+244,6μg/min) than in normoalhuminuria patients(165.7±90.3μg/ min) or in control subjects (184.1±96.9μg/min) and also significantly (p<0.005) higher in the group with overt proteinuria (370.6±331.6μg/min) than in microalbuminuria (277.9±244.6μg/min) or in normoalbuminuria (165.7±90.3μg/min) 3) Significant (p<0.01, p<0.001) degree of correlation were found between urine fibronectin excretion rate and duration of diahetes (r=0.31) or systolic blood pressure(r=0.35), where as AKR significnatly (p<0.01) correlated with duration of disease (r=0,27). 4) Urine fibronectin excretion rate were, significantly ocrrelated with AER(r=0.13, p<0.001) Conclusion: The results of this study suggest that FER is a useful indicator for the occurrence and progression of early diabetic nephropathy.
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