Plasma proteins production and excretion in diabetic nephropathy in type II diabetic patients

Abstract

Diabetic nephropathy is the leading cause of chronic renal disease and a major cause of cardiovascular mortality in both developed and developing countries. In type II diabetes patients with normoalbuminuria, fibrinogen production is increased, whereas that of albumin is normal. It is not known whether hepatic albumin production in albuminuric type II diabetes patients is also increased, and whether fibrinogen production is further increased in these patients. Knowledge of these potential relationships is important to understand both the mechanistic associations between albuminuria and hyperfibrinogenaemia. Therefore, this study was designed to measure fibrinogen and albumin concentrations in patients with type II diabetes who had normal or increased urinary albumin excretion. Subjects, materials, and methods: Plasma albumin, and fibrinogen concentrations and urinary albumin are measured in macroalbuminuric diabetic patients (n=16), microalbuminuric diabetic patients (n=16), and healthy controls (n=8).Results: A direct relationship was found between albuminuria and albumin concentration (r=0.59, p<0.05). Direct relationship also found between albuminuria and fibrinogen concentration (r=0.65, p<0.002), and fibrinogen pool (r=0.66, p<0.002).

Conclusions: this study demonstrates that albumin and fibrinogen levels are increased in macroalbuminuric type II diabetes subjects compared with type II diabetes patients with microalbuminuria and healthy subjects , showing an upregulation of hepatic secretory proteins in this clinical condition. Such an upregulation seems to be responsible for the relative hyperfibrinogenaemia observed in the albuminuric diabetic patients.

Keywords: Plasma proteins, Diabetic nephropathy, Diabetes mellitus.