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In 73 healthy (group I) and 32 children and juveniles with insulin dependent diabetes mellitus (IDDM, group II) urinary albumin excretion is determined by radioimmunoassay (RIA). In both groups albumin excretion is observed in every urine sample when measured by RIA (mean +/- SD: group I: 7-19 h: 5.17 +/- 5.28 mg, 19-7 h: 3.86 +/- 4.00 mg, 24 h: 9.03 +/- 8.60 mg; group II: 7-19 h: 6.68 +/- 6.86 mg, 19-7 h: 3.46 +/- 2.82 mg, 24 h: 10.13 +/- 9.25 mg). No significant difference is detected between the values of the two groups. However in diabetic patients a significant difference is observed between diurnal and nocturnal urinary albumin excretion. Microalbuminuria is defined as an albumin excretion above 30 mg/d and is present in 6.9% of the values in group I and in 3.1% in group II. The physiological limits of microalbuminuria in children and juveniles compared to adults and several methods of urine sampling are discussed.

The Fanconi-Bickel syndrome is characterized by tubular dysfunction, impaired metabolism of glucose and galactose and glycogenosis. Up to now the data of nineteen patients have been reported. In the following case firstly an abnormal body composition is described measuring the concentration of Potassium-40 with a Whole Body Radiation Counter. Before therapy an increased value of total body cell mass but no value of total body fat is measured. After therapy body weight increased while cell mass decreased and a value of fat had been observed. Concerning renal parameters a 60 fold elevation of the beta 2-microglobulin-clearance is noted.

In 73 healthy (group I) and 32 children and juveniles with insulin dependent diabetes mellitus (IDDM, group II) urinary albumin excretion is determined by radioimmunoassay (RIA) and kinetic nephelometry. Intention of the study is to examine, if the kinetic nephelometry is--as observed in adults--a suitable method also in children and juveniles to detect microalbuminuria (greater than 30 mg/d). In both groups albumin excretion is observed in every urine sample when measured by RIA. Because of it's higher threshold kinetic nephelometry detects albumin excretion only in a part of the urine samples. The correlation between the two methods is very high (r = 0.905, p less than 0.001, n = 174). So kinetic nephelometry is not suitable to determine reference values. But as a faster and possibly more specific method than RIA nephelometry is a very effective way for a screening of microalbuminuria also in children and juveniles.

Vitamin D-deficiency has been observed among immigrant children with rickets and osteomalacia in Western Europe. So vitamin D-status in 34 children and juveniles (17 girls, 17 boys) of African and Asian diplomats staying in West Germany only for a certain time is examined. During summer 1989 plasma levels of alkaline phosphatase, calcium, phosphate, 25-hydroxy-cholecalciferol and 1,25-dihydroxycholecalciferol is measured. According to their native country the subjects are divided into three groups: I North Africa (n = 7), II Central Africa (n = 18), III Asia (n = 9). No clinical signs of rickets or osteomalacia are detected. All plasma levels of calcium and phosphate are in the normal range so as most of the values of the alkaline phosphatase. In Group I 85.7% (n = 6), group II 77.8% (n = 14) and group III 44.4% (n = 4) have decreased values of 25-OHD whereas most strikingly elevated amounts of 1,25-OH2D are measured in 57.1% (n = 4) of the subjects in group I, 66.7% (n = 12) in group II and 11.1% (n = 1) in group III. Normal values for both 25-OHD and 1,25-OH2D are rare: one case (11.1%) in group I, no case in group II, four cases (44.4%) in group III. The influence of the time staying in West Germany on vitamin D-status, a possible dietary lack due to inadequate nutrition, the role of skin pigmentation and a potential genetic abnormality of vitamin D-metabolism is discussed to explain the results.

In 73 healthy (group I) and 32 children and juveniles with insulin dependent diabetes mellitus (IDDM, group II) urinary albumin excretion is determined by radioimmunoassay (RIA). In both groups albumin excretion is observed in every urine sample when measured by RIA (mean +/- SD: group I: 7-19 h: 5.17 +/- 5.28 mg, 19-7 h: 3.86 +/- 4.00 mg, 24 h: 9.03 +/- 8.60 mg; group II: 7-19 h: 6.68 +/- 6.86 mg, 19-7 h: 3.46 +/- 2.82 mg, 24 h: 10.13 +/- 9.25 mg). No significant difference is detected between the values of the two groups. However in diabetic patients a significant difference is observed between diurnal and nocturnal urinary albumin excretion. Microalbuminuria is defined as an albumin excretion above 30 mg/d and is present in 6.9% of the values in group I and in 3.1% in group II. The physiological limits of microalbuminuria in children and juveniles compared to adults and several methods of urine sampling are discussed.

The determination of fructosamine in serum of healthy newborns, children and adolescents by a new colorimetric method leads to an age-dependent reference range. Correction of the values for total protein yields a median of the results, which is not dependent on age and the upper limit of the reference range is not significantly different from that of healthy adults; this does not hold true for referral to albumin. As the half-life time of glycated serum proteins is shorter (mean 20 days) than that of hemoglobin A1c, fructosamine can provide useful additional informations about the diabetic control of children and adolescents (medium-term record of blood glucose).