The Variability of 24-Hour, Overnight 12-Hour, and Morning One-Hour, Urinary Albumin Excretion in Normoalbuminuric and Microalbuminuric Hospitalized Diabetics

住院糖尿病患正常白蛋白和微白蛋白尿期三種不同時段尿液白蛋白泄量的變動性

辛錫璋(Shyi-Jang Shin) ； 李洮俊(Yau-Jiunn Lee) ； 蕭碧容(Pi-Jung Hsiao) ； 林鈴(Ling Lin) ； 王淑芬(Shu-Fen Wang) ； 張峯紫(Fown-Tzu Chang) ； 莊惠珍(Fe-Jeng Chuang) ； 蔡瑞熊(Juei-Hsiung Tsai)

《The Kaohsiung Journal of Medical Sciences》 6卷9期 (1990/09) Pp. 511-516

https://doi.org/10.6452/KJMS.199009.0511

摘要

本文在探討住院糖尿病人不同時段尿液收集白蛋白排泄量（albumin excretion rate，AER）的變動性。依據第一次夜間12小時AER將糖尿病人分為二組：第一組為7名正常白蛋白尿糖尿病人（Normoalbuminuric diabetics，Na DM)，第一次夜問12小時AER小於10μg/min；第二組為7名微白蛋白尿糖尿病人(Microalbuminuric diabetics，Ma DM)AER等於或大於10μg/min014名病人均住院收集24小時、夜間12小時和早晨1小時尿液共連續三天，以放射免疫分析法測定尿液白蛋白濃度，並求出各時段三次AER的變動性係數百分比（Percentage of Coefficients of Variation，%CV)0NaDM組24小時、夜間12小時和早晨1小時尿液收集時段之％CV分別為60.0％、60.3％和74.5%，而MaDM組分別為29.9％、31.8％和50.9％。在MaDM組三種收集時段的％CV並無統計學上的差異，在NaDM組亦同。對每一種收集時段，NaDM和MaDM組亦無統計學上的差異。對夜間12小時尿液收集法，觀察第二。三次的AER是否影響到第一次AER對糖尿病人的分組。我們發現有三位MaDM病人各有一次AER小於10μg/min，有二位NaDM病人各有一次AER大於10μg/min而影響第一次AER對糖尿病人的分組。以上結果獲知，住院糖尿病人24小時尿液收集AER的變動性並不比夜間12小時AER為大，但是二群病人三種不同時段尿液收集AER變動性均相當高且對病人的分組會有影響，所以對住院糖尿病人想早期測知為正常白蛋白或微白蛋白尿期，亦須多次測定尿液AER。

並列摘要

lbumin excretion rates (AER) of three consecutive days in different urine collection periods were measured in 7 hospitalized microalbuminuric diabetics (Ma DM) and 7 normoalbuminuric diabetics (Na DM). They were divided on the basis of an initial overnight urinary AER below or above 10 fig/mm. The percentage of variation coefficients (% CV) of 24-hour, overnight 12-hour, and morning one-hour urine collections in Ma DM were 29.9%, 31.8% and 50.9%, respectively; while in Na DM group were 60.0%, 60.3% and 74.5%, respectively. There was no significant difference in the variation of AER among the three different urine collection procedures in both Ma DM and Na DM groups, or for similar urine collection between the two groups. The initial AER was compared to the subsequent two AERs in overnight 12-hour collection. The results were that three Ma DM patients had a subsequent AER below 10 g/min and two Na DM patients had a subsequent AER above 10 jig/mm on a single occasion. Therefore, the high variability of both groups would be expected to result in category changes. Multiple urine collections are needed to detect the early diabetic nephropathy for the hospitalized diabetics.

並列關鍵字

microalbuminuria ； diabetes mellitus