インスリン非依存型糖尿病患者の喫煙習慣と尿細管問質障害

Abstract

Cigarette smoking is known to promote the progression of diabetic ne- phropathy, but its effect on tubulointerstitial injury has not been established. We therefore examined the relationship between smoking and urinary excretion of β₂-microglobulin (β₂ MG) and N-acetyl-β-D-glucosaminidase (NAG) in 50 microalbuminuric patients with non -insulin-dependent diabetes mellitus. Total tobacco consumption was measured in pack- years (PY). Subjects were divided into three groups based on PY ; group Ⅰ (non-smokers), group Ⅱ (smokers, < 40 PY), and group Ⅲ (smokers, ≧ 40 PY). No significant difference in urinary albumin excretion or creatinine clearance was observed among these 3 groups. Urinary β₂MG excretion was significantly higher in group Ⅲ than in group Ⅰ, and urinary NAG excretion was significantly higher in group Ⅱ than in group Ⅰ. In conclusion, cigarette smokers manifest tubular proteinuria, suggesting that tobacco smoke may have an adverse effect on the renal tubulointerstitium.