糖尿病網膜症と糖尿病腎症との関連

Relation between diabetic retinopathy and nephropathy

　内科外来通院中のインスリン非依存型糖尿病患者488例について，腎症重症度別に網膜症合併頻度を調査したところ，腎症の重症度が上がるにつれ網膜症合併頻度は増加していた。しかしながら，持続蛋白尿を呈した96例中，増殖型網膜症がなかった症例は32例（33％）で，増殖型網膜症57例中，微量アルブミン尿さえも認められなかった症例は8例（14％）にのぼり，糖尿病網膜症と糖尿病腎症の進展は必ずしも同じではなかった。また，単純型糖尿病網膜症で腎症があった症例では，腎症がなかった症例に比べ黄斑浮腫の合併が有意に高く，糖尿病黄斑浮腫の合併に腎症が影響している可能性が示唆された。

We reviewed 488 diabetic patients regarding retinopathy and nephropathy during the first 7 months, 1991. All the patients suffered from noninsulin dependent diabets mellitus, NIDDM. The series did not include patients undergoing renal hemodialysis therapy. Retinopathy was present in 206 patients, 42.2%. Nephropathy was present in 312 patients, 64.0%. The incidence and severity of retinopathy were positively correlated with the severity of nephropathy. In eyes with simple retinopathy, there was a higher incidence of maculopathy when associated by persistent proteinuria. There was no detectable sign of nephropathy in 8 of 57 patients with proliferative retinopathy, 14%. Conversely, 32 out of 96 patients with persistent proteinuria, 33%, did not manifest proliferative retintpathy. While nephropathy was not necessarily associat-ed with retinopathy in diabetic patients, association of nephropathy tended to aggravate retinopathy.