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KMID : 0377219990240020063
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Medical Journal of Chosun Univercity
1999 Volume.24 No. 2 p.63 ~ p.70
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The clinical significance of serum type IV collagen in diabetic complications
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Kim Dong-Min
Lee Ki-Ju
Kim Hyun-Lee
Moon Gyu
Lee Ji-Hyun
Jeong Joong-Wha
Lee Bong-Kyu
Kim Hee-Joong
Bae Hak-Yeon
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Abstract
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Objective and Method: In diabetes mellitus, serum concentration of type IV collagen is important in the progression of diabetic microangiopathy. In this study, serum concentrations of type IV collagen were measured in 34 healthy controls and 87 noninsulin-dependent diabetes mellitus(NIDDM) and examined with the development of diabetic nephropathy and retinopathy.
Result: The present study revealed that serum levels of type IV collagen(by sandwich enzyme immuno assay, EIA) were more associated with retinopathy than nephropathy. A one-step sandwich enzyme immunoassay was used to measure the type IV-collagen level. The mean serum levels of type IV collagen (146.06±48.96ng/ml) in diabetetic patients were significantly higher than in healthy controls (101.6±4.42ng/ml). (p＜0.01) The mean serum levels of type IV collagen (221.5±67.46 ng/ml) in diabetic patients with proliferative diabetic retinopathy were significantly higher than in those with nonproliferative retinopathy (167.6±56.07ng/ml). (p＜0.01) and much more than in those with no retinopathy (134.30±37.04). (p＜0.01) The mean serum levels of type TV collagen in normoalbuminuria rose significantly as the degree of retinopathy progressed from no retinopathy to proliferative retinopathy stages(p＜0.01). Furthermore, the severity of retinopathy and nephropathy were closely associated with the serum type IV collagen level and the serum type IV collagen levels were significantly correlated with microalbuminuria.
Conclusion: The results of this study suggest that the serum type IV collagen was a useful and noninvasive marker for the development of diabetic microangiopathy, it could also be used to predict the development of diabetic complications and to assess therapeutics or the prognosis of diabetes. In diabetic cataract patients, the prognosis after cataract surgery was related with presence of diabetic retinopathy. Therefore high values of type IV collagen level in serum may be useful in predicting poor prognosis after cataract surgery in patients with diabetes mellitus. The usefulness of this model will be clarified by a larger scale study.
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KEYWORD
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Type IV collagen, Diabetic microangiopathy, Cataract
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