RENAL INTERSTITIAL EXPANSION IN INSULIN-DEPENDENT DIABETES-MELLITUS
RENAL INTERSTITIAL EXPANSION IN INSULIN-DEPENDENT DIABETES-MELLITUS
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DOI：
10.1038/ki.1993.95
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发表时间：
1993-03-01
影响因子：
19.6
通讯作者：
MAUER, SM
中科院分区：
文献类型：
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作者：
LANE, PH;STEFFES, MW;MAUER, SM
对84例胰岛素依赖型糖尿病患者进行了肾功能和定量肾脏形态测量学研究，包括系膜体积分数（Vv（mes/glom））、小动脉玻璃样变性指数、整体硬化肾小球百分比（%GS）和总肾皮质间质体积分数（Vv（int/T））。这四个参数之间有显着的相关性，所有四个结构参数与肾小球滤过率和尿白蛋白排泄的对数相关。多元逐步回归分析表明，Vv（mes/glom）和Vv（int/T）为加性关系，表明它们之间存在部分独立性。小动脉玻璃样变性和%GS没有进一步改善相关性。我们假设Vv（mes/glom）、Vv（int/T）、小动脉玻璃样变性和%GS代表了导致糖尿病肾病功能障碍的多种但可能相互关联的病理机制。糖尿病患者的纵向研究和无肾小球疾病的间质扩张疾病患者的研究可能有助于阐明间质扩张在糖尿病肾病中的独立作用。
Eighty-four patients with insulin-dependent diabetes mellitus had studies of renal function and quantitative renal morphometry including mesangial volume fraction (Vv(mes/glom)), index of arteriolar hyalinosis, percentage of globally sclerosed glomeruli (%GS), and interstitial volume fraction for total renal cortex (Vv(int/T)). There was significant correlation among these four parameters, and all four structural parameters correlated with glomerular filtration rate and the log of urinary albumin excretion. Stepwise multiple regression analysis showed that Vv(mes/glom) and Vv(int/T) were additive, suggesting that they are partially independent. Arteriolar hyalinosis and %GS did not improve the correlations further. We hypothesize that Vv(mes/glom), Vv(int/T), arteriolar hyalinosis, and %GS represent multiple but probably interrelated pathologic mechanisms leading to the functional disturbances of diabetic nephropathy. Longitudinal studies of patients with diabetes and studies of patients with diseases producing interstitial expansion in the absence of glomerular disease may help clarify the independent role of interstitial expansion in the kidney disease of diabetes mellitus.