CELL AND MATRIX COMPONENTS OF THE GLOMERULAR MESANGIUM IN TYPE-I DIABETES
CELL AND MATRIX COMPONENTS OF THE GLOMERULAR MESANGIUM IN TYPE-I DIABETES
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DOI：
10.2337/diabetes.41.6.679
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发表时间：
1992-06-01
期刊：
影响因子：
7.7
通讯作者：
MAUER, SM
中科院分区：
文献类型：
--
作者：
STEFFES, MW;BILOUS, RW;MAUER, SM
在横断面研究中，肾小球基底膜（GBM）宽度、系膜（V（v）Mes）、系膜细胞（V（v）Cell）和基质（V（v）Matx）组分的体积分数，对187例非糖尿病亲属活体供肾者和150例胰岛素依赖型糖尿病患者的肾活检组织进行了外周毛细血管表面密度（S（v）PGBM）的测定。1-41年的I型糖尿病。 在糖尿病患者中，基质是系膜扩张的主要因素。 然而，糖尿病患者的V（v）Cell（0.11 +/- 0.04）和V（v）Matx（0.20 +/- 10）均超过非糖尿病受试者的相同测量值（每种成分均为0.07 +/- 0.02）（每种情况下均为P < 0.001）。 线性回归分析显示GMB宽度、V（v）Mes、V（v）Cell、V（v）Matx或S（v）PGBM与尿白蛋白排泄和肌酐清除率之间存在显著相关性（均P < 0.001），所有白蛋白尿病例的相关系数均较高。 在结构参数中，通过逐步回归，V（v）Matx与任一功能测量相关性最好，GBM仅作为白蛋白尿的附加因素。 因此，尽管糖尿病肾小球病模型必须考虑系膜细胞和基质的增大，但结构性和功能性肾脏疾病进展的主要因素是系膜基质扩张。
In a cross-sectional study, glomerular basement membrane (GBM) width, the volume fractions of the mesangium (V(v)Mes), its cell (V(v)Cell) and matrix (V(v)Matx) components, and surface density of the peripheral capillary surface (S(v)PGBM) were measured in renal biopsies from 187 nondiabetic living related and cadaveric donors of kidneys for transplantation and from 150 patients with insulin-dependent (type I) diabetes mellitus of 1-41 yr duration. In the diabetic patients, the matrix was the major factor in the expansion of the mesangium. However, both V(v)Cell (0.11 +/- 0.04) and V(v)Matx (0.20 +/- 10) in diabetic patients exceeded the same measurements in nondiabetic subjects (0.07 +/- 0.02 for each component) (P < 0.001 in each case). Linear regression analysis demonstrated significant correlations (P < 0.001 for all) between GMB width, V(v)Mes, V(v)Cell, V(v)Matx, or S(v)PGBM and either urinary albumin excretion and creatinine clearance, with the higher correlation coefficients in all cases with albuminuria. Of the structural parameters, V(v)Matx correlated best with either functional measure by stepwise regression, with GBM as an added factor only with albuminuria. Therefore, although models of diabetic glomerulopathy must consider enlargement of both mesangial cells and matrix, the predominant factor in the progression of structural and functional renal disease is mesangial matrix expansion.