Diabetologia

, Volume 32, Issue 4, pp 219–226 | Cite as

Albuminuria reflects widespread vascular damage

The Steno hypothesis
  • T. Deckert
  • B. Feldt-Rasmussen
  • K. Borch-Johnsen
  • T. Jensen
  • A. Kofoed-Enevoldsen

Summary

Albuminuria in Type 1 (insulin-dependent) diabetes is not only an indication of renal disease, but a new, independent risk-marker of proliferative retinopathy and macroangiopathy. The coincidence of generalised vascular dysfunction and albuminuria, advanced mesangial expansion, proliferative retinopathy, and severe macroangiopathy suggests a common cause of albuminuria and the severe renal and extrarenal complications associated with it. Enzymes involved in the metabolism of anionic components of the extracellular matrix (e.g. heparan sulphate proteoglycan) vulnerable to hyperglycaemia, seem to constitute the primary cause of albuminuria and the associated complications. Genetic polymorphism of such enzymes is possibly the main reason for variation in susceptibility.

Key words

Diabetes albuminuria extracellular matrix heparan sulphate vascular dysfunction 

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Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • T. Deckert
    • 1
  • B. Feldt-Rasmussen
    • 1
  • K. Borch-Johnsen
    • 1
  • T. Jensen
    • 1
  • A. Kofoed-Enevoldsen
    • 1
  1. 1.Steno Memorial HospitalGentofteDenmark

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