Korean Journal of Nephrology 1998;17(2):275-281.

투석중인 만성신부전증 환자에서 혈청 Glycosyasted Albumin 및 Fructosamine에 관한 연구

조한선 , 이명희

Abstract

Glucose intolerance commonly occurs in patients with renal failure undergoing hemodialysis. Whether this mild glucose intolerance contributes to patho- genesis of uremic complication in unknown. Abnor- mally elevated levels of Hb A,have been reported in patients with chronic renal failure, whether or not they were undergoing hemodialysis. However serum levels of glycosylated albumin and fructosamine were not evaluated well. Our study was designed to examine fructosamine and glycosylated albumin to assess non-enzymatic glycosylation in patients with chronic renal failure undergoing maintenance dialysis(15 CAPD and 35 hemodialysis patients) and 33 healthy control subjects. Serum fructosamine levels were high in the hemodialysis patients(391.00±128.43 mmol/L, P<0.05) than control(268.91±8.31mo1/L) and CAPD pa- tients(267.7±1.27 mmo/L). And serum glycosylated albumin levels were also high in the hemodialysis patients(240@A043.99pmol/L, P<0.05) than control (146.22±24.88mmol/L) and CAPD patients(172.3± 42.89 m mol/L). After correction for serum albumin concentration, glycosylated albumin was raised in hemodialysis patients(6365.74±1307.98 m mol/L, P< 0.05) compare with control subject(3259.74±581.07m mol/g) and CAPD patients(4988.13 ± 1316.47 m mol/g). And after correction for serum albumin or protein, fructosmaine was raised in the hemodialysis patients (10282.06±3927.37, 3760.00±12600.00 p mol/g, respec- tively, P<0.05) compared with control(5705.81± 1411.36, 1906.67±6869.50mmol/g, respectively) and CAPD patients(7752.33±2260.16, 869.05±5919.35m mol/g , respectively) This result suggest that dialysis patients have increased protein glycosylation espe- cially in case of hemodialysis patients, most likely reflecting increased non-enzymatic glycosylation of serum protein by impaired glucose tolerance.