| Co-Investigator(Kenkyū-buntansha) |
EMOTO Masanori Osaka City University, 医学部, Research Associate (90275248)
KAWAGISHI Takahiko Osaka City University, 医学部, Lecturer (60224739)
NISHIZAWA Yoshiki Osaka City University, 医学部, Professor (00128745)
INABA Masaaki Osaka City University, 医学部, Associate Professor (00176405)
MATSUMOTO Naoki Osaka City University, Postgraduate Student
田原 英樹 大阪市立大学, 医学部, 助手 (60305620)
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| Budget Amount *help |
¥2,800,000 (Direct Cost: ¥2,800,000)
Fiscal Year 1999: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1998: ¥2,200,000 (Direct Cost: ¥2,200,000)
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| Research Abstract |
In order to explore the effect of arteriosclerosis and genetic factor on intrarenal hemodynamic abnormalities in patlents with 2 diabetes mellitus (DM), restive index (RI values) of interlobar artery of the kidney was measured with use of duplex Doppler sonography. 1. Relationship between glomerular filtration rate (GFR) and arteriosclerosis (systemic and intrarenal). In 61 DM patients, GFR's, parameters of systemic arteriosclerosis (IMT and stiffness- β of the carotid arteries) and RI values were measured. Multiple regression analysis showed that GFR were significantly affected by IMT, stiffness-β, and RI values, thus showing GFR are affected by systemic and intrarenal arteriosclerosis. (Taniwaki H, et al. Diabetes Care 21 : 1848-1855, 1988). 2. Effect of genotype of angiotensin converting enzyme (ACE) and nitric oxide synthase (ecNOS) on intrarenal hemodynamics. 123 DM patients were enrolled. Frequency of each genotype of ACE (II, ID or DD) and ecNOS (4a allele + or -) is not signifi
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cantly different in various stage of diabetic nephropathy. RI values were significantly affected by age and duration of DM, but not by ACE or ecNOS genotypes. The results suggest intrarenal hemodynamics were affected largely by arteriosclerosis. (Taniwaki H, et al. in submission). 3. Intrarenal hemodynamic abnormalities in chronic renal failure (CRF) patients. 48 DM-CRF and 42 nonDM-CRF patients were enrolled. RI values in DM-CRF patients were significantly higher than those of nonDM-CRF. Multiple regression analysis showed that RI values were significantly affected by the presence of DM, age, and serum creatinine (RィイD12ィエD1=0.563, p<0.0001), suggesting advanced renal arteriosclerosis in DM-CRF patients (Matsumoto N, et al. Nephron, in press). 4. Effect of vasodilating agents on intrarenal hemodvnamics 118 DM patients were enrolled. Both before and after nitroglycerine (NTG) 0.3 mg administration, RI values were measured. Compared to control subjects, decrease in RI values by NTG is significantly lower in DM. Particularly, DM patients with smoking or with advanced nephropathy stage had a significantly less responsiveness to NTG (Matsumoto et al, Diabetic Nephropathy, in press). Furthermore, changes in RI values after intravenous administration of arginine were significantly less in DM patients, suggesting impairment of endothelial cell dependent vasodilation in DM patients (Kawagishi T, et al. Arterioscler Thromb Vas Biol 19 : 2509-2516, 1999). Less
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