PMID- 7883578
OWN - NLM
STAT- MEDLINE
DCOM- 19950411
LR  - 20061115
IS  - 0018-2052 (Print)
IS  - 0018-2052 (Linking)
VI  - 43
IP  - 4
DP  - 1994 Dec
TI  - Serum and urinary type IV collagen concentrations in the assessment of diabetic 
      microangiopathy.
PG  - 123-33
AB  - We investigated the role of measurement of serum and urinary type IV collagen 
      (IV-C) levels in monitoring diabetic microangiopathy. Furthermore, we compared 
      these levels in diabetic nephropathy and non-diabetic renal disease (NDRD). A 
      one-step sandwich enzyme immunoassay was used to measure IV-C levels in 82 
      diabetic patients, 33 NDRD patients and 20 healthy non-diabetic control subjects. 
      The diabetic patients were classified into four groups according to urinary 
      albumin/creatinine index (ACI) (mg/g) and serum creatinine (s-Cr) (mg/dl): 
      normoalbuminuria (ACI < 30), microalbuminuria (ACI 30-300), albuminuria (ACI > 
      300, s-Cr < 1.99 mg/dl) and renal insufficiency (s-Cr > 1.99 mg/dl). Serum and 
      urinary IV-C levels were significantly elevated even in diabetic patients without 
      clinical evidence of microangiopathy compared with control subjects (p < 0.05 and 
      p < 0.01, respectively). Both levels were significantly higher in 
      normoalbuminuric patients than in the control subjects, and in patients with 
      microalbuminuria, albuminuria or renal insufficiency than in normoalbuminuric 
      patients, with significant differences between these groups (serum and urinary 
      IV-C, both p < 0.0001 by ANOVA). Urinary IV-C and albumin levels were 
      significantly correlated, even in normo- and microalbuminuric patients (r = 0.55, 
      p < 0.0001). Serum IV-C in normoalbuminuric patients rose significantly as the 
      degree of retinopathy progressed from background to proliferative stages (p < 
      0.05). Neither serum nor urinary IV-C levels were influenced by glycemic control. 
      Albuminuric diabetic patients (with and without renal insufficiency) had 
      significantly higher levels of serum IV-C compared with those in proteinuric NDRD 
      patients (p < 0.005), though there was no significant difference in the urinary 
      IV-C level. However, the urinary IV-C/albumin ratio was significantly higher in 
      albuminuric diabetic patients than in proteinuric NDRD patients, even after 
      adjusting for s-Cr and creatinine clearance (p < 0.0001). In conclusion, we 
      suggest that measured serum and urinary IV-C concentrations may serve as new 
      markers for monitoring the development and progression of diabetic 
      microangiopathy, particularly nephropathy. Furthermore, the measurement of serum 
      IV-C concentrations and urinary IV-C/albumin ratios in diabetic patients may 
      allow diabetic nephropathy and non-diabetic renal disease to be differentiated.
FAU - Banu, N
AU  - Banu N
AD  - Second Department of Internal Medicine, Hiroshima University School of Medicine, 
      Japan.
FAU - Hara, H
AU  - Hara H
FAU - Egusa, G
AU  - Egusa G
FAU - Yamakido, M
AU  - Yamakido M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Japan
TA  - Hiroshima J Med Sci
JT  - Hiroshima journal of medical sciences
JID - 0421060
RN  - 9007-34-5 (Collagen)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Albuminuria/blood/urine
MH  - Collagen/*blood/*urine
MH  - Diabetic Angiopathies/*blood/*urine
MH  - Diabetic Nephropathies/blood/urine
MH  - Female
MH  - Humans
MH  - Kidney Diseases/blood/urine
MH  - Male
MH  - Middle Aged
EDAT- 1994/12/01 00:00
MHDA- 1994/12/01 00:01
CRDT- 1994/12/01 00:00
PHST- 1994/12/01 00:00 [pubmed]
PHST- 1994/12/01 00:01 [medline]
PHST- 1994/12/01 00:00 [entrez]
PST - ppublish
SO  - Hiroshima J Med Sci. 1994 Dec;43(4):123-33.