1987 年 153 巻 2 号 p. 145-150
TADA, H., TAKEUCHI, S., TAKAGI, M. and ISOGAI, S. The Effect of Glycemic Control on Plasma Soluble Fibrin Monomer Complexes and Fibronectin in Diabetic Patients. Tohoku J. exp. Med., 1987, 153 (2), 145-150-We have shown previously that increased concentrations of plasma soluble fibrin monomer complexes (SFMC) and elevated fibronectin (Fn) levels are closely related to the development of diabetic microangiopathy. The purpose of the present study was to explore whether or not changes in plasma glucose levels could have an effect on these protein constituents. Plasma glucose levels of 25 uncontrolled diabetic patients were brought under control with insulin and serial measurements of SFMC and Fn were made over a period of 4 weeks. Glucose values fell from an average of 312mg/100ml to 160mg/100ml. Ten patients with macroproteinuria (i.e.≥ 0.5g/24hr) showed initially elevated plasma SFMC and Fn concentrations. These levels fell significantly over the 4 week observation period: from 13.6mg/100ml to 9.4mg/100ml for SFMC and from 38.4mg/100ml to 34.5mg/100ml for Fn. The remaining 15 patients had nearly normal levels of both SFMC (7.9mg/100ml) and Fn (31.1mg/100ml) and glycemic control brought no further reduction. The data indicated that a) elevated SFMC and Fn levels are indeed associated with diabetic microangiopathy, especially in the presence of macroproteinuria; and b) adequate glycemic control is capable of normalizing the plasma concentration of these constituents.
