糖尿病患者における血清および尿中Ｚｎの変動　　じん糸球体機能との関係

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タイトル別名
  • Urinary Excretion and Serum Levels of Zinc in Diabetics, and Its Relationship to Renal Damage
  • トウニョウビョウ カンジャ ニ オケル ケッセイ オヨビ ニョウチュウ Zn
  • 腎糸球体機能との関係

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Abnormal levels of zinc (Zn) in the serum and urine have recently been reported in diabetics. However the correlation between the Zn levels in the serum or urine and the severity of renal glomerular dysfunction has not yet been clarified. In order to examine such relationships, we investigated 62 diabetics with or without diabetic nephropathy (28 males, 34 females; average age 53.8 yr) and 11 healthy controls (6 males, 5 females; average age 48.5 yr). The following results were obtained.<BR>1) The levels of urinary Zn excretion in diabetics treated with insulin injection (41.2±4.6 (×10-2μg/min), p<0.01 M±SE) were more significantly elevated than those of controls (18.7±5.1 (×10-2μg/min)). The levels of serum Zn declined significantly in diabetics treated with insulin injection (59.5±4.6μg/dl, p<0.001) and those treated with diabetic oral agents (67.3±3.4μg/dl, p<0.01) as compared with controls (81.2±3.2μg/dl).<BR>2) A linear correlation was observed between the concentration of urinary protein and that of urinary Zn (y=0.73X+18.9, r=0.570, p<0.001). However, this correlation was not matched for 3 cases with severe stage of diabetic nephropathy.<BR>3) A significant correlation was observed between the serum levels of Zn (calculated as log X) and the degree of creatinine-clearance (Ccr)(y=47.7log X-19.0, r=0.656, p<0.0001). The urinary protein excretion was significantly elevated compared to that of controls when the Ccr was below 70 ml/min and above 100 ml/min. On the other hand, the urinary Zn excretion was significantly enhanced at these degrees of Ccr: 55-70 ml/min and 100-115 ml/min (p<0.01).<BR>4) The value of the Zn-clearance (Czn) was significantly elevated at levels of Ccr below 75 ml/min and above 100 ml/min, and the Czn/Ccr ratio at each Ccr level was elevated associated with decrease of the Ccr.<BR>Based on these data, it is concluded that in diabetic with a slight degree of glomerular dysfunction, the levels of urinary Zn excretion were correlated to the levels of urinary protein excretion. However, at the severe stage of diabetic nephropathy, such a relation could not be detected. The reason for no elevation of urinary Zn excretion in diabetics with severe stage nephropathy may be a deficiency of serum Zn associated with active chelation of certain catabolic agents.

収録刊行物

  • 糖尿病

    糖尿病 25 (6), 697-704, 1982

    一般社団法人 日本糖尿病学会

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