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Urinary excretion of retinol-binding protein in type 1 (insulin-dependent) diabetic patients with microalbuminuria and clinical diabetic nephropathy

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Abstract

The urinary excretion of retinol-binding protein (RBP) was studied in 101 insulin-dependent diabetic patients allocated to three groups according to 24-h urinary albumin excretion rate (UAE) (median of three urine collections): group 1 (n=45), normal UAE<30 mg/24h; group 2 (n=27), microalbuminuria (UAE 30–300 mg/24 h); and group 3 (n=29), clinical diabetic nephropathy (UAE>300 mg/24 h). We used 23 healthy subjects as controls. Fractional clearance of RBP (FC-RBP) and its 24-h urinary excretion rate (URBP) were higher in each diabetic group than in healthy subjects, the highest values being found in group 3. Groups 1 and 2 did not differ in URBP and FC-RBP. There was a correlation between FC-RBP and haemoglobin A1c in both the total diabetic cohort (P<0.001) and in diabetic patients in groups 1 and 2 with a glomerular filtration rate of more than 90 ml/min (P<0.05). No correlation was found between FC-RBP and UAE and/or duration of diabetes in any of the diabetic groups. We conclude that the increased urinary excretion of RBP, indicating proximal tubular dysfunction, is already present in normoalbuminuric insulindependent diabetic patients and correlates with metabolic control. Further deterioration in proximal tubular function was not observed in microalbuminuric patients, but is a late event in clinical diabetic nephropathy.

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References

  1. Mogensen CE, Hypertension in diabetes and the stages of diabetic nephropathy. Diabetic Nephropathy 1:2, 1982

    Google Scholar 

  2. Viberti GC, Hill RD, Jarrett RJ, Argyropoulos A, Mahmud U, Keen H, Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet I:1430, 1982

    Google Scholar 

  3. Parving HH, Noer J, Deckert T, Evrin PE, Nielsen SL, Lyngsoe J, Mogensen CE, Rorth M, Svendsen PA, Trap-Jensen J, Lassen NA, The effect of metabolic regulation on microvascular permeability to small and large molecules in short-term juvenile diabetics. Diabetologia 12:161, 1976

    Google Scholar 

  4. Poortmans J, Dorchy H, Toussaint D, Urinary excretion of total protein albumin and beta2-microglobulin during rest and exercise in diabetic adolescents with and without retinopathy. Diabetes Care 5:617, 1982

    Google Scholar 

  5. Watts GF, Rowe DF, Anthony A, Shaw KM, Polak A, Urinary excretion of retinol-binding protein in diabetics. Clin Sci 69 [Suppl 12]:41, 1985

    Google Scholar 

  6. Kanai M, Raz A, Goodman DS, Retinol-binding protein: the transport for vitamin A in human plasma. J Clin Invest 47:2025, 1968

    Google Scholar 

  7. Peterson PA, Berggard I, Isolation and properties of a human retinol-transporting protein. J Biol Chem 246:25, 1971

    Google Scholar 

  8. Rask L, Anundi H, Boehme J, Eriksson U, Fredriksson A, Nilsson SF, Ronne H, Vahlquist A, Peterson PA, The retinol-binding protein. Scand J Clin Lab Invest 40 [Suppl 154]:45, 1980

    Google Scholar 

  9. Feldt-Rasmussen B, Dinesen B, Deckert M, Enzyme immunoassay — an improved determination of urinary albumin in diabetics with incipient nephropathy. Scand J Clin Lab Invest 45:539, 1985

    Google Scholar 

  10. Jensen T, Deckert T, Dawnay A, Feldt-Rasmussen B, MicroELISA for the quantitation of human urinary and serum retinol-binding protein. Diabetes Res 10:93, 1989

    Google Scholar 

  11. Larsen K, Creatinine assay by a reaction-kinetic principle. Clin Chim Acta 41:209, 1972

    Google Scholar 

  12. Svendsen PAA, Christiansen JS, Soegard U, Welinder BA, Nerup J, Rapid change in chromatographically determined haemoglobin A1c induced by short-term changes in glucose concentration. Diabetologia 19:130, 1980

    Google Scholar 

  13. Beetham R, Silver A, Dawnay A, Urinary albumin and retinol-bingding protein in diabetes. Clin Chem 33:713, 1987

    Google Scholar 

  14. Holm J, Hemingsen L, Nielsen NV, Thomsen M, Increased urinary excretion of the retinol-binding protein in insulin-dependent diabetes mellitus in the absence of microalbuminuria. Clin Chim Acta 170:345, 1987

    Google Scholar 

  15. Watts GF, Powell M, Rowe DJF, Shaw KM, Low-molecular-weight proteinuria in insulin-dependent diabetes mellitus: a study of the urinary excretion of beta2-microglobulin and retinol-binding protein in alkalinized patients with and without microalbuminuria. Diabetes Res 12:31, 1989

    Google Scholar 

  16. Rowe DJF, Anthony F, Polak A, Shaw K, Ward CD, Watts GF, Retinol-binding protein as a small molecular weight marker of renal tubular function in diabetes mellitus. Ann Clin Biochem 24:477, 1987

    Google Scholar 

  17. Watanabe Y, Nunoi K, Maki Y, Nakamura Y, Fujishima M, Contribution of glycaemic control to the levels ofN-acetyl-beta-D-glucosaminidase and serum NAG in type 1 (insulin-dependent) diabetes mellitus without macroalbuminuria. Clin Nephrol 28:227, 1987

    Google Scholar 

  18. Deckert T, Feldt-Rasmussen B, Djurup R, Deckert M, Glomerular size and charge selectivity in insulin-dependent diabetes mellitus. Kidney Int 33:100, 1988

    Google Scholar 

  19. Bastable MD, Beta2-microglobulin in urine: not suitable for assessing renal tubular function. Clin Chem 29:996, 1983

    Google Scholar 

  20. Bernard AM, Moreau D, Lauwerys DR, Comparison of retinol-binding protein and beta2-microglobulin determination in urine for the early detection of tubular proteinuria. Clin Chim Acta 126:1, 1982

    Google Scholar 

  21. Bernard A, Amor AO, Goemare-Vanneste J, Antoine JL, Lauwerys R, Colin I, Vandeleene B, Lambert A, Urinary proteins and red blood cell membrane negative charges in diabetes mellitus. Clin Chim Acta 190:249, 1990

    Google Scholar 

  22. Beetham R, Dawnay A, Landon J, Cattell WR, A radioimmunoassay for retinol-binding protein in serum and urine. Clin Chem 31:1364, 1985

    Google Scholar 

  23. Topping MD, Forster HW, Dolman C, Luczynska CM, Bernard AM, Measurement of urinary retinol-binding protein by enzyme-linked immunosorbent assay, and its application to detection of tubular proteinuria. Clin Chem 32:1863, 1986

    Google Scholar 

  24. Lind B, Jensen T, Feldt-Rasmussen B, Deckert T, Normal urinary albumin excretion in recently diagnosed type 1 diabetic patients. Diabetic Med 6:682, 1989

    Google Scholar 

  25. Gibb DM, Tomlinson PA, Dalton NR, Turner C, Shah V, Barratt TM, Renal tubular proteinuria and microalbuminuria in diabetic patients. Arch Dis Child 64:129, 1989

    Google Scholar 

  26. Michels LD, Davidman M, Keane WF, Glomerular permeability to neutral and anionic dextrans in experimental diabetes. Kidney Int 21:699, 1982

    Google Scholar 

  27. Abrass KC, Diabetic proteinuria, glomerular or tubular in origin? Am J Nephrol 4:337, 1984

    Google Scholar 

  28. Mathiesen ER, Oxenboll R, Johansen K, Svendsen PA, Deckert T, Incipient nephropathy in Type 1 (insulin-dependent) diabetes. Diabetologia 26:406, 1984

    Google Scholar 

  29. Feldt-Rasmussen B, Mathiesen ER, Jensen T, Lauritzen T, Deckert T, Effect of improved metabolic control on loss of kidney function in Type 1 (insulin-dependent) diabetic patients: an update of the Steno studies. Diabetologia 34:164, 1991

    Google Scholar 

  30. Mathiesen ER, Hommel E, Giese J, Parving HH, Efficacy of captopril in postponing nephropathy in normotensive insulindependent diabetic patients with microalbuminuria. BMJ 303:81, 1991

    Google Scholar 

  31. Holm J, Hemmingsen L, Nielsen NV, Relationship between the urinary excretion of albumin and retinol-binding protein in insulin-dependent diabetics. Clin Chm Acta 177:101, 1988

    Google Scholar 

  32. Mutti A, Alinovi R, Ghiggeri GM, Bergamaschi E, Candiano G, Rasi A, Gusmano R, Franchini I, Borghetti A, Urinary excretion of brush-border antigen and plasma proteins in early stages of diabetic nephropathy. Clin Chim Acta 188:93, 1990

    Google Scholar 

  33. Deckert T, Parving HH, Thomsen OF, Jorgensen HE, Brun C, Thomsen AC, Renal structure and function in type 1 (insulindependent) diabetic patients: a study of 44 kidney biopsies. Diabetic Nephropathy 4:163, 1985

    Google Scholar 

  34. Sumpio BE, Maack T, Kinetics, competition and selectivity of tubular absorption of proteins. Am J Physiol 243:F379, 1982

  35. Smith FR, Raz A, Goodman DS, Radioimmunassay of human plasma retinol-binding protein. J Clin Invest 49:1754, 1970

    Google Scholar 

  36. Vahlquist A, Johnsson A, Nygren KG, Vitamin A transporting plasma proteins and female sex hormones. Am J Clin Nutr 32:1433, 1979

    Google Scholar 

  37. Bernard A, Vyskocíl A, Mahieu P, Lauwerys R, Effect of renal insufficiency on the concentration of free retinol-binding protein in urine and serum. Clin Chim Acta 171:85, 1988

    Google Scholar 

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Authors and Affiliations

  1. Steno Memorial Hospital, Gentofte, Denmark

    P. Pontuch, T. Jensen & T. Deckert

  2. Department of Internal Medicine 1, Medical Faculty, Comenius University, Bratislava, Czechoslovakia

    P. Pontuch, P. Ondrejka & M. Mikulecky

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  1. P. Pontuch
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  2. T. Jensen
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  3. T. Deckert
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  4. P. Ondrejka
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  5. M. Mikulecky
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Pontuch, P., Jensen, T., Deckert, T. et al. Urinary excretion of retinol-binding protein in type 1 (insulin-dependent) diabetic patients with microalbuminuria and clinical diabetic nephropathy. Acta Diabetol 28, 206–210 (1992). https://doi.org/10.1007/BF00779000

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