Diabetes Care, Vol 18, Issue 1 1-9, Copyright © 1995 by American Diabetes Association

ARTICLES

Increased transcapillary escape rate of albumin in microalbuminuric type II diabetic patients

M Nannipieri, L Rizzo, A Rapuano, A Pilo, G Penno and R Navalesi
Chair of Metabolic Diseases, University of Pisa, Italy.

OBJECTIVE--To evaluate microvascular permeability by the transcapillary escape rate of albumin (TERalb) in type II diabetic patients with normo- and microalbuminuria. RESEARCH DESIGN AND METHODS--The TERalb has been measured following intravenous injection of 125I-labeled human serum albumin in 32 normotensive type II diabetic patients and 9 healthy control subjects matched for sex and age. Type II diabetic subjects were grouped in normoalbuminuric, albumin excretion rate (AER) < 20 micrograms/min (n = 18), and microalbuminuric, AER 20-200 micrograms/min (n = 14) categories. RESULTS--In type II diabetic patients, no differences were noted between normo- and microalbuminuric groups for known diabetes duration (8.3 +/- 5.9 vs. 11.7 +/- 8.0 years), blood pressure (BP) (129/76 +/- 16/8 vs. 131/76 +/- 14/5 mmHg), current metabolic control (HbA1c: 8.0 +/- 1.4 vs. 8.5 +/- 1.6%), and serum lipids. However, previous 2-year mean HbA1c levels were significantly higher in microalbuminuric patients (8.7 +/- 1.45 vs. 7.6 +/- 1.29%; P < 0.05). The TERalb was similar in control subjects and normoalbuminuric patients (5.16 +/- 1.09 vs. 5.71 +/- 1.66 %/h) and significantly higher in the microalbuminuric group (8.98 +/- 1.35 %/h; P < 0.0001). The increased leak of albumin was not explained by differences in diabetes duration, BP, or metabolic control at the time of investigation and was independently related to the presence of microalbuminuria (r = 0.63, percent explained variance approximately 40) and mean "historical" HbA1c (multiple r = 0.705; total explained variance approximately 50%). CONCLUSIONS--Type II diabetic patients with microalbuminuria show an increased TERalb, i.e., a widespread microvascular damage that may be important in the pathogenesis of long-term complications. Our findings may contribute to the explanation of why albuminuria seems to be an independent cardiovascular risk factor in type II diabetes.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Xu, E. T Lee, L. G Best, M. Begum, W. C Knowler, R. R Fabsitz, and B. V Howard Association of albuminuria with all-cause and cardiovascular disease mortality in diabetes: the Strong Heart Study The British Journal of Diabetes & Vascular Disease, November 1, 2005; 5(6): 334 - 340. [Abstract] [PDF]

				K. Klausen, K. Borch-Johnsen, B. Feldt-Rasmussen, G. Jensen, P. Clausen, H. Scharling, M. Appleyard, and J. S. Jensen Very Low Levels of Microalbuminuria Are Associated With Increased Risk of Coronary Heart Disease and Death Independently of Renal Function, Hypertension, and Diabetes Circulation, July 6, 2004; 110(1): 32 - 35. [Abstract] [Full Text] [PDF]

				S. T. Knudsen, T. Bek, P. L. Poulsen, M. N. Hove, M. Rehling, and C. E. Mogensen Macular Edema Reflects Generalized Vascular Hyperpermeability in Type 2 Diabetic Patients With Retinopathy Diabetes Care, December 1, 2002; 25(12): 2328 - 2334. [Abstract] [Full Text] [PDF]

				A. N. Friedman, L. G. Hunsicker, J. Selhub, A. G. Bostom, and The Collaborative Study Group Proteinuria as a Predictor of Total Plasma Homocysteine Levels in Type 2 Diabetic Nephropathy Diabetes Care, November 1, 2002; 25(11): 2037 - 2041. [Abstract] [Full Text] [PDF]

				K. Kornerup, B. G. Nordestgaard, B. Feldt-Rasmussen, K. Borch-Johnsen, K. S. Jensen, and J. S. Jensen Transvascular Low-Density Lipoprotein Transport in Patients With Diabetes Mellitus (Type 2): A Noninvasive In Vivo Isotope Technique Arterioscler. Thromb. Vasc. Biol., July 1, 2002; 22(7): 1168 - 1174. [Abstract] [Full Text] [PDF]

				G. Heper, T. Durmaz, S. Namik Murat, and E. Ornek Clinical and Angiographic Outcomes of Diabetic Patients After Coronary Stenting: A Comparison of Native Vessel Stent Restenosis Rates in Different Diabetic Subgroups Angiology, May 1, 2002; 53(3): 287 - 295. [Abstract] [PDF]

				A. Melville, R. Richardson, J. Mason, A. McIntosh, C. O'Keeffe, J. Peters, and A. Hutchinson Complications of diabetes: screening for retinopathy and management of foot ulcers Qual. Saf. Health Care, June 1, 2000; 9(2): 137 - 141. [Full Text]

				M. Noakes and P. M Clifton Changes in plasma lipids and other cardiovascular risk factors during 3 energy-restricted diets differing in total fat and fatty acid composition Am. J. Clinical Nutrition, March 1, 2000; 71(3): 706 - 712. [Abstract] [Full Text] [PDF]

				R. Pedrinelli, G. Penno, G. Dell'Omo, S. Bandinelli, D. Giorgi, V. Di Bello, R. Navalesi, and M. Mariani Microalbuminuria and Transcapillary Albumin Leakage in Essential Hypertension Hypertension, September 1, 1999; 34(3): 491 - 495. [Abstract] [Full Text] [PDF]

				A. M. Schmidt, S. D. Yan, J.-L. Wautier, and D. Stern Activation of Receptor for Advanced Glycation End Products : A Mechanism for Chronic Vascular Dysfunction in Diabetic Vasculopathy and Atherosclerosis Circ. Res., March 19, 1999; 84(5): 489 - 497. [Abstract] [Full Text] [PDF]

				R. Pedrinelli, G. Penno, G. Dell'Omo, S. Bandinelli, D. Giorgi, V. Di Bello, M. Nannipieri, R. Navalesi, and M. Mariani Transvascular and Urinary Leakage of Albumin in Atherosclerotic and Hypertensive Men Hypertension, August 1, 1998; 32(2): 318 - 323. [Abstract] [Full Text] [PDF]

				C. M. Sue, P. Mitchell, D. S. Crimmins, C. Moshegov, E. Byrne, J. G.L. Morris, and D. M. Oxon Pigmentary retinopathy associated with the mitochondrial DNA 3243 point mutation Neurology, October 1, 1997; 49(4): 1013 - 1017. [Abstract] [Full Text] [PDF]

				A. Hempel, C. Maasch, U. Heintze, C. Lindschau, R. Dietz, F. C. Luft, and H. Haller High Glucose Concentrations Increase Endothelial Cell Permeability via Activation of Protein Kinase C{alpha} Circ. Res., September 19, 1997; 81(3): 363 - 371. [Abstract] [Full Text]

				E. M. Campbell, S. Redman, Pauls. Moffitt, and R. W. Sanson-Fisher The Relative Effectiveness of Educational and Behavioral Instruction Programs for Patients With NIDDM: A Randomized Trial The Diabetes Educator, January 1, 1996; 22(4): 379 - 386. [PDF]

				R. G. Hiss Barriers to Care in Non-Insulin-dependent Diabetes Mellitus: The Michigan Experience Ann Intern Med, January 1, 1996; 124(1_Part_2): 146 - 148. [Abstract] [Full Text]