influence of metabolic regulation
microvascular permeability of small and large molecules
Springer Online Journal Archives 1860-2000
Summary The microvascular permeability to small and large molecules was studied during good and poor metabolic regulation in ten short duration juvenile diabetics. The following variables were measured; daily urinary albumin and β2-microglobulin-excretion rates, whole body transcapillary escape rate of albumin (TER), glomerular filtration rate (GFR), capillary filtration coefficient (CFC), and capillary diffusion capacity (CDC). The urinary albumin and β2-microglobulin concentration were measured by sensitive radioimmunoassays; TER was determined from the initial disappearance of intravenously injected 125I-labelled human serum albumin; GFR was measured by single shot 51Cr-EDTA clearance; CFC was measured on the forearm by straingauge plethysmography and CDC for 51Cr-EDTA was determined in the hyperaemic anterior tibial muscle by the local clearance technique. All the above mentioned variables, except CDC, were significantly increased during poor metabolic regulation, indicating a functional microangiopathy. The mechanisms of these alterations appear to be increased filtration pressure in the microcirculation and/or increased porosity of the microvasculature. The findings of increased microvascular albumin passage are compatible with the hypothesis that the organic — histologically demonstrated — diabetic microangiopathy is a long-term effect of periods of increased extravasation of plasma proteins, with subsequent protein deposition in the microvascular wall, i. e. the concept of plasmatic vasculosis.
Type of Medium: