非对称性二甲基精氨酸与2型糖尿病及其大血管并发症关系的研究

Study of the association of serum asymmetric dimethyl arginine with macroangiopathy of type 2 diabetic mellitus

目的研究血清非对称性二甲基精氨酸(ADMA)与2型糖尿病及其大血管并发症的关系,观察强化治疗对ADMA水平的影响。方法 2型糖尿病患者97例(DM组),包括无大血管并发症亚组(DM1亚组)22例和伴大血管并发症亚组(DM2亚组)75例。所有患者均入院接受降糖和(或)降压、调脂等强化治疗2周,并于2个月后对患者进行随访。选取40例健康体检者作为正常对照组(NC组)。用酶联免疫法(ELISA)检测血清ADMA水平及生化仪器检测其他相关指标。用SPSS12.0软件包进行分析。结果 2型糖尿病两个亚组血清ADMA水平均明显高于正常对照组(P<0.05),且2型糖尿病伴大血管并发症亚组平均血清ADMA水平高于2型糖尿病无大血管并发症亚组(P<0.05)。多元线性回归分析显示,在2型糖尿病组(DM组)中糖化血红蛋白(HbA1c)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)均与ADMA水平呈正相关。经强化治疗后其血清ADMA水平明显下降(P<0.05)。结论血清ADMA水平与2型糖尿病及其大血管并发症密切相关,与HbA1c、TC和LDL-C均呈正相关。强化治疗可以使2型糖尿病患者血清ADMA水平明显下降。

Objective To investigate the relationship between serum asymmetric dimethylarginine（ADMA）and macrovascular complications of type 2 diabetic mellitus（T2DM） and to observe the effect of intensification therapy on the level of serum ADMA in T2DM patients.Methods 97 cases with T2DM were selected,including 75 patients with macroangiopathy（DM2 sub-group）and 22 patients without macroangiopathy（DM1 sub-group）.All patients were hospitalized and treated with intensification therapy for not only blood glucose,but also blood pressure and blood fat if necessary.After that they were followed up two months later.The levels of serum ADMA were measured with ELISA.SPSS 12.0 software package was used to analyze the data.Results The mean level of serum ADMA in T2DM patients with and without macroangiopathy were obviously elevated than that in control group（P0.05）,and serum ADMA concentration in DM2 sub-group was significantly higher than DM1 sub-group（P0.05）.Multiple linear regression analysis showed that serum ADMA was positively correlated to HbA1c,TC,LDL-C.After intensification therapy serum ADMA level in T2DM patients（n=30）was significantly decreased（P0.05）.Conclusions The level of serum ADMA is closely associated with T2DM and its macroangiopathy,also positively correlate to HbA1c,TC,LDL-C.Intensification therapy could reduce the concentration of serum ADMA in T2DM patients.