糖尿病性腎症における尿中酵素測定の意義

Abstract

Diagnostic significance of the determination of urinary enzymes in diabetic nephropathy was evaluated by comparison with the histological findings of renal biopsy specimens. The subjects were 40 diabetics who were divided by the stage of diffuse lesions of the glomeruli based on Gellman's criteria into four groups of D0, DⅠ, DⅡ～Ⅲ, and DⅣ, and by the stage of tubulo-interstitial lesions into T0 (almost normal), TⅠ (focci of tubular atrophy and fibrosis), TⅡ (moderate interstitial fibrosis), and TⅢ (extensive tubular atrophy with fibrosis). With the urine excreted during the one-hour period of resting, the excretion of urinary albumin (ALB), β2-microglobulin (β2MG), N-acetyl-β-D-glucosaminidase (NAG), leucine aminopeptidase (LAP) and γ-glutamyl transpeptidase (γGTP) were quantified. The ALB showed a significant correlation with the stage of glomerular diffuse lesions and the β2MG was significantly higher in TⅢ than in T0, TⅠ, and TⅡ. The NAG and yGTP showed no differences among the tubulo-interstitial lesions different stage while the LAP was significantly higher in TⅢ than in T0, TⅠ, and TⅡ. From these results, it seems unlikely that the measurment of those urinary enzymes offers an early indicator for tubulo-interstitial lesions secondary to diabetic nephropathy.