糖基化终末产物对糖尿病慢性并发症的早期诊断价值

Assess the Early Diagnostic Value of AGEs to Diabetes with Chronic Complicating Diseases

目的探讨糖基化终末产物（AGEs）与糖尿病慢性并发症之间的关系及在糖尿病（DM）诊断中的作用。方法2012年9月～2013年3月在大港鹾院就诊的糖屎嫡患者87例，其中单纯糖尿病患者21例，同时伴脑梗死患者16例，伴冠心病患者29例，律肾病患者11例；倬眼痫患者10例。对照组50例，为健康献血员，均无糖尿病、脑梗死、冠心痛、肾病及眼病病史。各组患者同时检测AOEs、空腹血糖和糖化血红蛋白（HbAle）水平。采用竞争法原理的酶联免疫吸附试验（ELISA）检测糖基化终末产物（AGEs）；采用葡萄糖氧化酶法检测空腹血糖；采用HPLC法检测HbAlc。结果AGEs水平分别为：单纯糖尿病组8．89±0．29U／ml，糖尿病伴脑梗死组13．69±o．64U／ml，糖尿病伴冠心病组14．13±0．55u／ml，糖尿病伴肾病组12．2±0．337U／m1，糖尿病伴眼病组13．25±0．24U／ml，与对照组比较AGEs水平均有显著性升高，差异有统计学意义（q=4．117～6．523，P值均〈0．01）。同单纯糖尿病组相比，糖尿病伴脑梗死组、糖尿病伴冠心病组、糖尿病伴肾病组、糖尿病伴眼病组AGEs水平均有显著性升高，差异有统计学意义（q=3．443～3．756，P值均〈0．05）。糖尿病伴慢性并发症各组间AGEs水平差异无统计学意义（F=0．326，P〉0．05）。单纯糖尿病组及糖尿病伴各种并发症组，其AGEs水平同血糖水平、HbAlc水平呈正相关（r=0．416-0.452，P值均〈0．01）。结论血清AGEs水平的升高是早期诊断糖尿病并发各种慢性并发薤酌重要指标；而ELISA以其快速灵敏准确且无放射性污染的特点，适于在·临床实验室中作为常规检测AGEs的方法。

Objective Assess the early diagnostic value of AGEs to diabetes （DM） with chronic complicating diseases. Meth- ods Collected 87 diabetes patients who therapy in Dagang Hospital from September 2012 to March 2013,including 21 cases pure diabetes, 16 cases with cerebral infarctioh 29 cases with cototlary heart disease, 11 cases with kidney disease, 10 cases with oculopathy. 50 cases healthy person as conttol group,which Were no medical history with diabetes,cerebral infarction, coronary heart disease,kidney disease,and ocultopathya DeteCted AGEs,GLU and HbAlc at the same time. AGEs was detec- ted by ELISA;GLU was detected by glueosie oXidase metht3d; HbAle wad detected by HPLC. Results The AGEs value of group of DM only （group A） was 8.89±0.29 U/ial,DM with cerebrai infarction （group B） was 13.69±0.64 U/ml,DM with coronary heart disease （group C） was 14.13±0. 55 U/ml,DM with nephropathy （group D） was 12.2±0. 337 U/ml, and DM with eye disease （group E） was 13.25±0.24 U/mi, ThE AGEs value of groupA,B,C,D,E was significant higher than group control （q=4. 117~6. 523,P〈0.01） The AOEs value of group B,C,D,E was higher than group A （q=3. 443 -3. 756, P〈0.05）. The AGEs value had no significant difference betweetJ the group complicating disease （F= 0. 326, P〉 0.05）. The value of AGEs,GLU and HbAlc had plus correlatiort （r=0, 416~0, 452 ,P〈O. 01）. Conclusion The higher se- rum value of AGEs is an important indicator for diagnose DM more earlier, ELISA is fit for detecting AGEs as routine meth- od because of its quick, sensitive and accuracy,especially （3~ no radioactive pollution.