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FUPING PAN, JANET L. STEVENSON, DAVID L. DONALDSON, JANET LEVY, THOMAS WIEGMANN, WAYNE V. MOORE, Correlation of Urinary Albumin and β-2-Microglobulin and Growth Hormone Excretion in Patients with Diabetes Mellitus and Short Stature, The Journal of Clinical Endocrinology & Metabolism, Volume 71, Issue 3, 1 September 1990, Pages 611–617, https://doi.org/10.1210/jcem-71-3-611
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We examined the correlation between urinary GH, urinary albumin, and β-2-microglobulin excretion to determine how the excretion of GH relates to markers of renal glomerular and tubular function. Urinary albumin and GH excretion was determined in timed daytime and nighttime urine collections obtained from both subjects with diabetes mellitus and subjects with short stature. For subjects with diabetes, urinary GH excretion rate correlated highly with urinary albumin concentration and excretion rate in both the range of 0 to 1.6 g/L (r = 0.75), P < 0.001) and in the microalbuminuria range, 0 to 0.4 g/L (r = 0.53, P < 0.001). Changes in GH and albumin excretion occurred in parallel in 71% of the subjects with diabetes and elevated albumin excretion. The mean GH excretion rate was higher in the group with elevated albumin excretion rate (AER) during both day and night compared to the group with microalbuminuria during the day and normal AER at night. For subjects with short stature, the mean albumin excretion rate was 0.7 ± 1.3 μg/min (range 0.05–8.3 μg/min) using a sensitive enzyme-linked immunosorbent assay to measure albumin concentration. The correlation of GH and albumin excretion rates for the subjects with short stature was not statistically significant (r = 0.14, P > 0.5). About half of the subjects with diabetes and elevated AER (>10 μg/min) had a GH excretion rate within the range observed in subjects with short stature. The GH and albumin excretion rate were not correlated in this group. There was a positive correlation of both albumin and GH excretion rate with age in the subjects with diabetes.
Urinary GH and β-2-microglobulin excretion rates were determined in a larger group of subjects with diabetes and a separate group with short stature. Urinary GH and β-2-microglobulin excretion were correlated both in subjects with diabetes (r = 0.46, P < 0.001) and with short stature (r = 0.64, P < 0.001). The association was present in urine collected either during the day or night. The mean GH excretion rate of the group with diabetes was greater than the group with short stature.
In conclusion, there was an association of urinary GH and albumin excretion rate in subjects with abnormal glomerular function as indicated by elevated albumin excretion rate. An association of urinary GH and β-2-microglobulin excretion was observed in subjects with normal tubular function. Urinary GH excretion may be an additional marker for early diabetic nephropathy but may not be a reliable indicator of endogenous GH production in subjects with normal or depressed GH production.
