Original Article

Ann Clin Biochem 1992; 29: 265-270

Glomerular and tubular proteinuria in Type 1 (insulin-dependent) diabetic patients with and without retinopathy P Martin, H Tindall, J N Harvey, T M Handley", C Chapman! and J A Davies From the University Departments of Medicine and Chemical Pathology', The General Infirmary, Leeds, UK

We compared the urinary excretion of albumin, transferrin, N-acetylo-l-microglcbulin in 78 Type 1 (insulin-dependent) diabetic patients: 39 with retinopathy and 39 without. The two groups were matched for age, sex and duration of diabetes. The patients with retinopathy had increased excretion (median and range) of albumin [1'7 (0' 3-399·1) versus 1·0 (0' 3-116'6) mg/mmol creatinine, P O' 3 giL)

Patients with retinopathy

Patients without retinopathy

39 52(2) 23'1(1'6) 23/16 143(5)· 79(2)· 6 10'9(0'3)

39 48(3) 22'2(1' 5) 23/16 131(3) 73(1) 2 10'6(0'3)

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·P0'4 in each case).

On multiple regression analysis in the pooled group (n = 78) the excretion ratios of the urinary proteins measured did not correlate with age, duration of diabetes, glycaemic control, blood pressure, or urinary glucose excretion. However, in patients without retinopathy, urinary Nacetyl-d-Dcglucosaminidase excretion correlated significantly with urinary glucose concentration (r,=0'61, P.

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FIGURE 1. Correlation of urinary transferrin with urinary albumin excretion in Type 1 diabetic patients with (closed circles) and without (open circles) retinopathy. Broken lines indicate 95th centiles for normal adult controls.

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0·1 ',0 10 102 0'1 1'0 10 102 103 Urinary N-ccetyl-B-D-gkJcoscminidase Urinarya-I-micrcglcbulin excretion (Ummol- I creatinine) excretion (mg rnrnol" creatinine) FIGURE 2. Correlation of (a) urinary o-I-microglobulin and (b) N-acetyl-{j-D-glucosaminideexcretion with urinary albumin excretion in Type 1 diabetic patients with (closed circles) and without (open circles) retinopathy. Broken lines indicate 95th centiles for normal adults.

excretion ratios (5/39 abnormal albumin and 18/39 raised transferrin (x2:6'7, P