Albuminuria reflects widespread vascular damage: The Steno hypothesis
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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.
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Endothelial dysfunction may be an underlying cause of many associated vascular problems.
“Endothelial dysfunction may be an underlying cause of many associated vascular problems ( 45 , 54 ).”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [54]
In “Albuminuria, more than an indicator of renal disease” (page not provided), the paper links markers of endothelial dysfunction with albuminuria and proposes that a widespread vascular process promotes retinopathy and macroangiopathy. In “Loss of heparan sulphate proteoglycan in diabetes” (page not provided), it proposes loss of heparan sulphate as a mechanism affecting endothelial cells and other tissues. It does not specifically identify endothelial dysfunction itself as the underlying cause of the associated vascular problems. (LLM, conf=0.82)
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- Authors
- Deckert, T., Feldt-Rasmussen, B., Borch-Johnsen, K., Jensen, T., & Kofoed-Enevoldsen, A.
- ORCID
- Jensen, T.
- Venue
- Diabetologia
- Published
- 1989-04
- Volume
- 32
- Issue
- 4
- Pages
- 219-226
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2335631045
- Cited by
- 1,400
- References
- 105
- Citations by year
- 2026: 15 · 2025: 15 · 2024: 17 · 2023: 34 · 2022: 16 · 2021: 33 · 2020: 28 · 2019: 34 · 2018: 31 · 2017: 38 · 2016: 46 · 2015: 35 · 2014: 48 · 2013: 53 · 2012: 50
- FWCI
- 10.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Nephrology › Renal Diseases and Glomerulopathies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Keywords
- albuminuria, type 1 diabetes, proliferative diabetic retinopathy, macroangiopathy, vascular dysfunction, mesangial expansion, heparan sulfate proteoglycans, extracellular matrix, hyperglycemia, genetic polymorphism, diabetic nephropathy, risk indicators
- MeSH terms
- Albuminuria, Diabetes Mellitus, Type 1, Diabetic Angiopathies, Diabetic Nephropathies, Humans, Models, Theoretical, Biomarkers
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