Korean Journal of Nephrology 1996;15(4):519-526.

인슐린 비의존형 당뇨병 환자에서 당뇨병성 신증의 지표로서 혈청과 IV형 collagen의 의의

장태종 , 최병진 , 반금진 , 노영호 , 김소연 , 조민구 , 이권진 , 김윤권

Abstract

To evaluate the usefulness of serum and urinary concentrations of type IV collagen as a marker of glomerular basement membrane metabolism and the severity of diabetic nephropathy, we measured serum and urinary concentrations of type IV collagen-7S in 69 patients with non-insulin dependent diabetes and in 20 control subjects. And we compared serum and urinary concentrations of type IV collagen with the severity of diabetic nephropathy and glomerular filtration rate. The results were as follows- 1) The mean serum concentrations of type IV collagen was significantly higher in diabetic patients without nephropathy(4.50±1.48ng/ml) than in control subjects(3.55± 0.47ng/ml)(p<0.05). 2) The mean serum concentrations of ±type IV collagen was significantly higher in diabetic patients with microalbuminuria(5.86±4 1.66ng/ml) than in dia- betic patients without nephropathy(p<0.05). 3) The mean ratio of urinary type IV collagen/ urine creatinine was significantly higher in diabetic patients with microalbuminuria(23.04±9.06) than in diabetic patients without nephropathy(8.15±5.55) (p< 0.05). 4) The serum concentrations of type IV collagen became higher as the glomerular filtration rate declined(r=-0.39, p<0,01). 5) The mean ratio of urinary type IV collagen/ creatinine became higher as the glomerular filtration rate declined(r=-0.57, p<0.01). These results suggest that serum and urinary concentrations of type IV collagen seem to be a useful, noninvasive and mproducible marker for assess- ment of glomerular basement membrane metabolism and urinary concentrations of type IV collagen may have a role as an indicator of early diabetic nephro- pathy in patients with non-insulin dependent diabetes.