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Jacqueline M. Lopes de Faria, Lilia A. Silveira, Marcelo Morgano, Elizabete J. Pavin, José B. Lopes de Faria; Erythrocyte Sodium–Lithium Countertransport and Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2000;41(6):1482-1485.
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purpose. To investigate whether elevated erythrocyte
(Na+/Li+ CT) activity is present in patients
with proliferative diabetic retinopathy (PDR).
methods. The rate of Na+/Li+ CT activity assayed in 21
patients with type 1 diabetes mellitus (DM) presenting PDR was compared
with 10 patients with nonproliferative retinopathy (NPDR) and with 11
patients with normal fundi. Twelve normal volunteers with no family
history of hypertension were used as a control group. The albumin
excretion rate was determined by nephelometry, and the glomerular
filtration rate was measured by the plasma clearance of eidetic acid
labeled with chromium-51.
results. Patients with PDR showed higher diastolic blood pressure levels
(mean ± SD) compared with those with NPDR or normal fundi
(95 ± 13 versus 90 ± 09 and 82 ± 19 mm Hg, P = 0.02, respectively). The albumin excretion rate
was higher [geometric mean (range)], and the glomerular filtration
rate was lower (mean ± SD) in patients with PDR than in those
with NPDR or normal fundi [333 (2 to 5140) versus 32 (5.9 to 2200) and
6 (1.5 to 306) μg/min, P = 0.01, and 63 ±
33 versus 99 ± 37 and 93 ± 43 ml/min, P = 0.02, respectively]. The mean Na+/Li+ CT in
patients with PDR was significantly higher than in patients with NPDR
or normal fundi and control group (0.46 ± 0.20 versus 0.32 ± 0.12, 0.32 ± 11, and 0.21 ± 0.07 mM/L red blood cells
(RBC)/h, respectively, P = 0.0001). In a multiple
logistic regression analysis, with PDR as the dependent variable,
Na+/Li+ CT (odds ratio [OR]: 4.7, confidence
interval [CI]: 1.2–17.6, P = 0.02), diastolic
blood pressure (OR, 3.4; CI, 1.3 to 9.6; P =
0.018), and glomerular filtration rate (OR, 5.1; CI, 1.6–17.7; P = 0.007) were the only variables that were
maintained in the equation, indicating that they were the main
determinants of PDR.
conclusions. Patients with type 1 DM and proliferative retinopathy have elevated
erythrocyte Na+/Li+ CT.
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