缺血修饰白蛋白与2型糖尿病合并下肢动脉病变的关系

Relation between serum ischemia-modified albumin levels and peripheral artery disease in type 2 diabetic patients

目的探讨T2DM合并下肢动脉病变(PAD)患者血清缺血修饰白蛋白(IMA)的变化与意义。方法测定T2DM患者踝肱指数(ABI)筛查PAD,以ABI<0.9或≥1.3为界点分为PAD组(n=70)和非PAD组(n=117),分析两组在IMA及代谢参数方面的差异,探讨IMA与代谢参数相关性,并分析PAD的危险因素。结果 PAD组的糖尿病病程、HbA1c、UAlb、胰岛素抵抗指数(HOMA-IR)高于非PAD组,PAD组IMA水平显著低于非PAD组(P<0.05);IMA与HbA1c呈负相关,与其他参数无相关性。Binary logistic回归分析显示,糖尿病病程、HbA1c、UAlb及IMA为PAD危险因素或危险标志物。结论 PAD患者血清IMA降低,IMA与HbA1c呈负相关;IMA为PAD的危险标志物。

Objective To explore the changes of serum ischemia-modified albumin(IMA) levels in type 2 diabetes(T2DM) patients with and without peripheral artery disease(PAD).Methods ABI was examined in the patients with T2DM.The patients were divided into PAD group(ABI<0.9 or ABI>1.3) and non-PAD group(0.9<ABI<1.3).The concentration of serum IMA and clinical characteristics,including blood pressure,fasting and postprandial blood glucose,HbA1c,lipid profiles,fasting serum insulin levels,and urinary albumin(UAlb) were measured.Results The patients with abnormal ABI(ABI<0.9 or >1.3) showed longer duration of diabetes(8.5±2.2) vs(5.3±1.7)y,higher levels of HbA1c(9.1±0.3)% vs(7.6±0.3)%,logUAlb(1.6±0.7) vs(1.4±0.5),ln HOMA-IR(1.4±0.6) vs(1.1±0.6),and lower serum IMA levels(75.0±3.1) vs(97.1±5.4)U/ml.IMA were negatively associated with HbA1c(r=-0.220,P=0.03).Binary logistic regression analysis showed that duration of diabetes,HbA1c,logUAlb,and IMA were the independent risk factors or biomarker for PAD(all P<0.05).Conclusions The serum IMAs are significantly lower in PAD patients,and are associated with HbA1c,which can act as a useful biomarker of PAD.