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  • 1
    Electronic Resource
    Electronic Resource
    Association between Mannose-Binding Lectin and Vascular Complications in Type 1 Diabetes (2004)
    Oxford, UK; Malden, USA : Blackwell Science Ltd/Inc.
    Scandinavian journal of immunology 59 (2004), S. 0 
    Details
    ISSN: 1365-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Complement activation and inflammation have been suggested in the pathogenesis of diabetic vascular lesions. We investigated serum mannose-binding lectin (MBL) levels and polymorphisms in the MBL gene in type 1 diabetic (T1DM) patients with and without diabetic nephropathy and associated macrovascular complications. Polymorphisms in the MBL gene and serum MBL levels were determined in 199 T1DM patients with overt nephropathy and 192 T1DM patients with persistent normoalbuminuria matched for age, sex and duration of diabetes as well as in 100 healthy control subjects. The frequencies of high and low expression MBL genotypes were similar in patients with T1DM and healthy controls. High MBL genotypes were significantly more frequent in diabetic patients with nephropathy than in the normoalbuminuric group, and the risk of having nephropathy, given a high MBL genotype, assessed by odds ratio was 1.52 (1.02–2.27), P = 0.04. Median serum MBL concentrations were significantly higher in patients with nephropathy than in patients with normoalbuminuria [2306 µg/l (IQR 753–4867 µg/l) versus 1491 µg/l (IQR 577–2944), P = 0.0003], and even when comparing patients with identical genotypes, serum MBL levels were higher in the nephropathy group than in the normoalbuminuric group. Patients with a history of cardiovascular disease had significantly elevated MBL levels independently of nephropathy status [3178 µg/l (IQR 636–5231 µg/l) versus 1741 µg/l (IQR 656–3149 µg/l), P = 0.02]. The differences in MBL levels between patients with and without vascular complications were driven primarily by pronounced differences among carriers of high MBL genotypes (P 〈 0.0001). Our findings suggest that MBL may be involved in the pathogenesis of microvascular and macrovascular complications in type 1 diabetes and that determination of MBL status might be used to identify patients at increased risk of developing these complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0300-9475.2004.01423i.x
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  • 2
    Electronic Resource
    Electronic Resource
    Distribution and degradation of albumin in extensive skin disease (1981)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 104 (1981), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The distribution and degradation of albumin were determined in twelve patients with extensive skin disease and in ten control subjects by measuring the metabolic turnover and transcapillary escape of 131I-labelled albumin. The ratio of intravascular to total mass of albumin was normal. Thus the observed hypoalbuminaemia and the low intravascular mass reflect a reduced mass of total body albumin. The rate of synthesis was normal, but the transcapillary escape rate reflecting the micro-vascular leakiness to macromolecules, and the fractional disappearance rate were significantly higher n i the patients than in the controls (P〈0·001). It is concluded that the hypoalbuminaemia in these patients is the result of an increased endogenous catabolism of albumin without signiflcant loss via urine, stools or skin. A positive correlation between the transcapillary escape rate and fractional catabolic rate of albumin supports the concept of a causal relationship between these parameters.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1981.tb15308.x
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  • 3
    Electronic Resource
    Electronic Resource
    The relationship between kidney size and function in short-term diabetic patients (1982)
    Springer
    Diabetologia 22 (1982), S. 494-494 
    Details
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00282601
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  • 4
    Electronic Resource
    Electronic Resource
    Kidney function and size in type 1 (insulin-dependent) diabetic patients before and during growth hormone administration for one week (1982)
    Springer
    Diabetologia 22 (1982), S. 333-337 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; glomerular filtration rate ; renal plasma flow ; kidney size ; growth hormone ; albumin ; β-2-microglobulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Kidney function and size were studied in seven well-controlled male Type 1 (insulin-dependent) diabetic patients before and after administration of highly purified human growth hormone for one week. Glomerular filtration rate, renal plasma flow (steady state infusion technique with urinary collections using 125I-iothalamate and 131I-hippuran), kidney size (ultrasonic scanning) and urinary excretion rates of albumin and β-2-microglobulin were measured. Highly purified growth hormone was injected subcutaneously, 2 IU in the morning and 4 IU in the evening. The growth hormone dosage applied induced an elevation in plasma growth hormone concentration from the normal level seen in these very well controlled diabetics to levels within the range previously demonstrated in normally controlled Type 1 diabetic patients. During the week of growth hormone administration, glycaemic control was maintained unchanged by increasing the insulin dose by 79 ±9% (mean ± SEM). Glomerular filtration rate increased from 122±3 to 131±3 ml/min × 1.73 m2 (p 〈0.05) and renal plasma flow increased from 535±10 to 569±22 ml/min × 1.73 m2 (p〈0.05). Kidney size changed from 128±5 to 133±5 ml/1.73 m2 (NS). Urinary excretion rates of albumin and β-2-microglobulin were unchanged. The present findings suggest that the growth hormone elevation typically found in Type 1 diabetic patients with reasonable clinical control, contributes to the enhanced glomerular filtration rate and renal plasma flow present in that disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00253577
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  • 5
    Electronic Resource
    Electronic Resource
    Haemodynamic changes in insulin-induced hypoglycaemia in normal man (1984)
    Springer
    Diabetologia 26 (1984), S. 328-332 
    Details
    ISSN: 1432-0428
    Keywords: Insulin-induced hypoglycaemia ; plasma volume ; heart rate ; cardiac output ; cardiac stroke volume ; blood pressure ; plasma catecholamines ; vascular resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Haemodynamic variables (plasma volume, heart rate, blood pressure, cardiac output, stroke volume, pulmonary tissue volume, total peripheral vascular resistance, hepato-splanchnic vascular resistance, lower extremity vascular resistance and plasma catecholamines) were measured before and after insulin-induced hypoglycaemia in seven healthy men. Plasma volume decreased significantly at the nadir of glucose (mean decrease 222±41 ml) and subsequently increased to pre-hypoglycaemic values within 30 min. Cardiac output increased in response to hypoglycaemia (mean increase 2.8±0.61/min). The early rise in cardiac output was primarily due to an increase in heart rate, but later mainly due to increased stroke volume. Since pulmonary tissue volume was constant, the observed changes in cardiac output are unlikely to be due to a Frank-Starling mechanism but rather to increased sympatho-adrenal activity. Total peripheral vascular resistance as well as lower extremity vascular resistance decreased, whereas hepato-splanchnic vascular resistance was unaffected. Thus insulin-induced hypoglycaemia has marked transient effects on the circulation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00266031
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  • 6
    Electronic Resource
    Electronic Resource
    Prevalence of microalbuminuria in children with Type 1 (insulin-dependent) diabetes mellitus (1986)
    Springer
    Diabetologia 29 (1986), S. 640-643 
    Details
    ISSN: 1432-0428
    Keywords: Arterial blood pressure ; children ; glycosylated haemoglobin ; retinopathy ; Type 1 diabetes ; urinary albumin excretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevalence of microalbuminuria was determined in children aged 7 to 18 years with Type 1 (insulin-dependent) diabetes of more than 2 years' duration. All patients (n =102) attending 2 diabetes clinics were asked to collect 2 overnight timed urine samples for albumin analysis by radioimmunoassay. Complete urine collection was obtained in 97 patients (95%). Overnight urinary albumin excretion rates were also measured in 36 healthy children matched for age and sex. Nineteen of the 97 patients (20%) had microalbuminuria, i. e. overnight urinary albumin excretion rates above the upper normal level (14 μg/min) in both urine collections. Microalbuminuria was only demonstrated in patients aged ≥ 15 years, prevalence 37% (19/52 patients). Arterial blood pressure was elevated, mean 122/84±11/9mmHg, in the microalbuminuric group (19 patients) compared to the age-matched normoalbuminuric diabetic group (33 patients), mean 117/74±10/10 mm Hg,p 〈 0.001. The prevalence of simplex retinopathy was identical in these two groups, i. e. 25%. Glycosylated haemoglobin was slightly higher in the microalbuminuric patients,p 〈 0.10. Our cross-sectional study reveals a high prevalence (37%) of persistent microalbuminuria, a stage highly predictive of later development of diabetic nephropathy, in Type 1 diabetic children aged ≥ 15 years.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00869263
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  • 7
    Electronic Resource
    Electronic Resource
    Effects of indomethacin on kidney function in Type 1 (insulin-dependent) diabetic patients with nephropathy (1987)
    Springer
    Diabetologia 30 (1987), S. 78-81 
    Details
    ISSN: 1432-0428
    Keywords: Albuminuria ; diabetic nephropathy ; glomerular filtration rate ; prostaglandins ; Type 1 diabetes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We investigated whether the glomerular synthesis of prostaglandins modulates the glomerular filtration rate and albumimiria in diabetic nephropathy. The urinary excretion of immunoreactive prostaglandin E2 (253pg/min) was significantly elevated in eight Type 1 (insulin-dependent) diabetic women with nephropathy as compared with nine normoalbuminuric Type 1 diabetic women (95pg/min) and 11 non-diabetic women (132 pg/min), respectively (p〈0.01). Glomerular filtration rate (single bolus 51Cr-EDTA technique) and albuminuria (radioimmunoassay) were measured twice within two weeks in the eight Type 1 diabetic women with nephropathy. All eight patients were on a diabetic diet without sodium restriction. The study was performed as a randomized doubleblind trial, with the patients receiving either indomethacin (150mg/day) or placebo for three days prior to the kidney function studies. Indomethacin treatment induced a significant reduction in urinary prostaglandin E2 excretion (73%, p〈0.01), glomerular filtration rate diminished from 120±18 to 106±17ml/min/1.73m2 (p〈0.05), albuminuria declined from 148 to 69 μg/min (median and range) (p〈0.05) and fractional clearance of albumin diminished 42% (p〈0.05). Blood glucose concentrations were comparable during the placebo and indomethacin treatment, 13.4±4 versus 14.2±3 mmol/l, respectively. Our results suggest that glomerular filtration rate in early diabetic nephropathy is dependent on the enhanced glomerular synthesis of vasodilating prostaglandins.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00274575
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  • 8
    Electronic Resource
    Electronic Resource
    A strong correlation between glomerular filtration rate and filtration surface in diabetic nephropathy (1988)
    Springer
    Diabetologia 31 (1988), S. 265-270 
    Details
    ISSN: 1432-0428
    Keywords: Diabetic glomerulopathy ; diabetic nephropathy ; glomerular ultrastructure ; glomerular filtration rate ; stereology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Quantitative structural studies were performed in kidney biopsy specimens from 24 long-term Type 1 (insulin-dependent) diabetic patients with persistent albuminuria due to diabetic glomerulopathy. Ten patients were receiving antihypertensive treatment, and among the remaining patients the mean blood pressure was 142/91 mmHg (SD = 11/9). The urinary albumin excretion rate showed a range from 100 to 5494 μg/min (geometric mean 688 μg/min.) Glomerular filtration rate also showed a wide range, from supranormal to markedly decreased values (128 to 28 ml·min−1· (1.73 m2)−1, mean 75). The filtration surface (interface between capillary and urinary space) per total number of nephrons (open+occluded) was estimated by combined light- and electron microscopy. The percentage occluded glomeruli as well as structural quantities in the open glomeruli were taken into account in this estimate. A highly significant correlation was seen between glomerular filtration rate and filtration surface per nephron (r=0.77, p〈10−4). The percentage occluded glomeruli contributed significantly to the variation in glomerular filtration rate (for this relationship tested separately r=-0.78, p〈10−5). The volume of open glomeruli was even larger than that seen in early diabetic glomerular hypertrophy and tended to increase with the percentage of glomerular closure, indicating that a compensatory hypertrophy might have taken place. In the open glomeruli the filtration surface constituted a smaller percent of total capillary surface (the remaining part facing the mesangial regions) than in early diabetic patients and control subjects. Our study has demonstrated that reduced glomerular filtration surface is closely associated with reduced glomerular filtration rate in Type 1 diabetic patients with diabetic nephropathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00277406
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  • 9
    Electronic Resource
    Electronic Resource
    Effect of protein kinase C modulators on the leucocyte Na+/H+ antiport in Type 1 (insulin-dependent) diabetic subjects with albuminuria (1991)
    Springer
    Diabetologia 34 (1991), S. 201-201 
    Details
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00418278
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  • 10
    Electronic Resource
    Electronic Resource
    Glomerular size- and charge selectivity in Type 2 (non-insulin-dependent) diabetic patients with diabetic nephropathy (1994)
    Springer
    Diabetologia 37 (1994), S. 195-201 
    Details
    ISSN: 1432-0428
    Keywords: Key words Type 2 (non-insulin-dependent) diabetes mellitus, diabetic nephropathy, IgG, IgG4, IgG/albumin selectivity index, IgG/IgG4 selectivity index.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In an attempt to evaluate the mechanisms of proteinuria in diabetic kidney disease, we measured the renal clearances of albumin, total IgG, and IgG4 in 20 male Type 2 (non-insulin-dependent) diabetic patients with diabetic glomerulosclerosis (biopsy proven), in 10 male Type 2 diabetic patients without nephropathy (urinary albumin excretion rate ≤ 30 mg/24 h), and in 10 healthy male subjects. The fractional clearance of albumin was increased in patients with nephropathy: 659 (42–4355) · 10–6 (median (range)), compared to 2.6 (0.2–14.2) · 10–6 in patients without nephropathy, and 2.3 (0.4–4.2) · 10–6 in healthy subjects. The fractional clearance of total IgG (neutral) and of IgG4 (anionic) was 40–50 times higher in patients with nephropathy compared to the two other groups. The IgG/IgG4 selectivity index was not significantly different in the three groups, being: 1.12 (0.06–5.65), 1.16 (0.45–3.72) and 1.35 (0.65–3.34) in patients with nephropathy, patients without nephropathy, and healthy subjects, respectively. The IgG/albumin selectivity index was decreased in patients with nephropathy: 0.27 (0.01–1.26) compared to 1.29 (0.07–2.67) (p〈0.05) and 1.23 (0.76–7.84) (p〈0.001) in patients without nephropathy and healthy subjects, respectively. No significant change in IgG/albumin selectivity index was observed between patients without nephropathy and healthy subjects. The systolic blood pressure was elevated in the patients with nephropathy: 164±21 mm Hg (mean ± SD) compared to patients without nephropathy: 145±20 mm Hg (p〈0.05) and to healthy subjects: 133±19 mm Hg (p〈0.005). The diastolic blood pressure was higher in patients with and without nephropathy: 92±7 vs 90±10 mm Hg compared to 79±8 mm Hg (p〈0.005) in healthy subjects. Our cross-sectional study suggests that impaired barrier size selectivity, probably due to an increase in large pore area (“shunt pathway”) in the glomerular capillary wall and systemic hypertension are the major pathogenic mechanisms of proteinuria in Type 2 diabetic patients with diabetic nephropathy. [Diabetologia (1994) 37: 195–201]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050093
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