尿中のアルバミンの分泌,心血管疾患,非インスリン依存型糖尿病における内皮機能不全
C D Stehouwer1, J J Nauta, G C Zeldenrust
1Department of Internal Medicine and Laboratory for Endocrinology, Bergweg Municipal Hospital, Rotterdam, Netherlands.
Lancet (London, England)
|August 8, 1992
まとめ
非インスリン依存性糖尿病 (NIDDM) の尿アルブミン分泌量 (UAE) の上昇は,心血管疾患に関連しています. フォン・ウィレブランド因子 (vWF) によって示される内皮機能障害は,この関連において重要な役割を果たします.
科学分野:
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
- 血管生物学 血管生物学
背景:
- 尿中のアルブミン排出量 (UAE) の上昇は,非インスリン依存性糖尿病 (NIDDM) の患者における心血管疾患 (CVD) の既知の危険因子です.
- NIDDMにおけるUAEとCVDを結びつける根本的なメカニズムは,まだ完全に理解されていません.
研究 の 目的:
- プラズマのフォン・ウィレブランド因子 (vWF) 濃度によって評価される内皮機能不全の役割を,NIDDM患者におけるUAEと心血管イベントの潜在的な仲介者として調査する.
- UAE,vWFレベル,および新たな心血管疾患の発生率との関係を調査する.
主な方法:
- 94人のNIDDM患者を対象に実施された前向きな研究で, UAEのベースラインレベルが変化した.
- UAEとプラズマのvWF濃度の測定 ベースラインとフォローアップ.
- 953ヶ月の期間における新しい心血管疾患のモニタリング.
主要な成果:
- 血のvWFレベルは,UAEが正常から上昇に進行した患者,および持続的に高いUAEを有する患者で有意に増加しました.
- ベースラインのvWFレベルとvWFの変化は,マイクロアルブミヌーリアの発生と強く相関していました.
- 高濃度のUAEは,主に高vWF濃度の患者で心血管疾患のリスクを増加させ,重要な要因として内皮機能不全を示唆しています.
結論:
- 増加したvWFによって示される内皮機能不全は,アルブミヌリアとNIDDMにおける動脈硬化性心血管疾患の発症の間の重要なリンクとして機能する可能性があります.
- vWFレベルは,高濃度のUAEを有するNIDDM患者における心血管リスクの有意な予測因子である.
- UAE,内皮機能障害,および脂質プロファイル (HDLコレステロール) の相互作用は,NIDDMにおける心血管リスクに影響します.
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