早期糖尿病及糖尿病足0级患者血浆羧甲基赖氨酸水平的变化及其影响因素

The detection of CML level in plasma in early stage of DM and diabetic foot of Grade 0 and discussing the influence factors

目的检测DM早期及糖尿病足(DF)0级血浆羧甲基赖氨酸(CML)水平,并探讨CML与糖代谢、病程、年龄的相关性。方法 45例DM早期患者(参照1999年WHO糖尿病诊断标准,且尿白蛋白排泄量<200μg/min或300mg/d;视网膜病变≤Ⅰ期),35例DF为0级的患者(参照Wagner诊断分级标准),检测空腹状态下血浆CML、FPG、HbA1c及PPG。结果 DF组较DM早期组年龄较大、病程较长,血浆CML水平明显升高(P<0.05)。DF 0级患者血浆CML水平在血糖控制不佳患者(HbA1c>7.0%)中显著升高,且均与HbA1c呈显著正相关(r=0.44,P<0.01);同时,CML与2hPG也呈显著正相关(r=0.41,P<0.05),CML与FPG、病程、年龄均无相关性(P>0.05)。结论 DF 0级患者CML水平显著升高,血浆CML与HbA1c、2hPG呈正相关,血浆CML也许是糖氧化的生物标记,且与糖尿病相关并发症有关。

Objective To detect the level of carboxymethyllysine （CML） in early stage o{ diabetes mellitu （DM） and grade 0 diabetic foot （DF） and discuss the relevance of CML with glucose metabolism, disease course and age. Methods 45 patients with early stage of DIM were diagnosed by 1999 WHO diagnostic criteria for diabetes, with urinary albumin excretion〈200/μg/min or 300 mg/d, retinopathy≤ period I and 35 patients with DF Grade 0. CML, HbA1 e, FPG and 2hPG were tested. Results There were older age, longer duration, higher level of CML in DF grade 0 group than in early stage of DM group （all P〈0.05）. The level of plasma CML in patients with poor glycemic control （HbA1c〉7.0%） in DF Grade 0 group was significantly increased and related to HbA1c and 2hPG positively （r= 0. 44, P〈O. 01 and r=0.41, P〈0. 05）. There was no correlation of CML with FPG, disease course and age, separately （P〉0. 05）. Conclusion The CML level increases significantly in DF Grade 0, which is positively correlated with HbA2 c and 2hPG. CML may be a biomarker o~ glucose oxidation and related with diabetes- related complications.