OCCUPATIONAL HYDROCARBON EXPOSURE AND DIABETIC NEPHROPATHY

Exposure to hydrocarbons has been implicated in the pathogenesis of gl omerulonephritis but its role in the development of diabetic nephropat hy remains unknown. Three groups of patients with Type 1 diabetes of o ver 10 years duration were studied. Group 1 comprised 45 patients (23 F) with no diabetic nephropathy (urinary albumin excretion (AER) < 30 mg 24 h-1), group 2 comprised 37 patients (17 F) with incipient diabet ic nephropathy (AER between 30-300 mg 24 h-1), and group 3 comprised 3 1 patients (15 F) with overt diabetic nephropathy (AER > 300 mg 24 h-1 ). The groups were comparable for age, sex, duration of diabetes, rece nt glycaemic control, social class, and residential area. Patients wer e assessed blindly by a validated questionnaire and interview for hydr ocarbon exposure, consumption of tobacco, analgesic agents, and alcoho l. Exposure scores to hydrocarbons derived from the questionnaire were significantly higher in patients with incipient and overt diabetic ne phropathy with smoking adjusted odds ratios of 3.6 and 5.2, respective ly. The consumption of alcohol, analgesic agents, tobacco, and smoking habits were similar in the three groups. In conclusion, hydrocarbon e xposure may be a key environmental factor in the development of diabet ic nephropathy in patients with Type 1 diabetes.