2型糖尿病患者皮肤和血清晚期糖基化终产物与代谢指标及微血管并发症的关系

The relationship between skin and serum advanced glycation end products,metabolic indexes and microvascular complications of type 2 diabetes mellitus

目的探讨T2DM患者皮肤和血清AGEs与代谢指标及微血管并发症的关系。方法选取2017年10月至2018年2月于云南省第一人民医院内分泌代谢科住院治疗的T2DM患者126例,根据免扩瞳眼底照相、UACR及eGFR,分为DR或早期DKD组(DR/DKD,n=58)、DR合并早期DKD组(DR+DKD,n=26)及单纯T2DM组(T2DM,n=42),检测皮肤及血清AGEs,分析其与年龄、DM病程、糖脂代谢指标的关系。结果T2DM、DR/DKD、DR+DKD组皮肤AGEs依次升高[(75.16±12.64)vs(82.12±12.59)vs(92.48±8.96),P<0.05]。DR+DKD组血清AGEs高于T2DM、DR/DKD组[(22.97±5.46)vs(13.68±5.14)vs(14.28±4.47)μg/ml,P<0.05]。Pearson相关分析显示,皮肤AGEs与年龄、FPG及LDL-C呈正相关(P<0.05),与BMI呈负相关(P<0.05);血清AGEs与HbA1c及LDL-C呈正相关(P<0.05)。结论T2DM患者皮肤和血清AGEs与代谢指标及DM微血管并发症相关,联合检测皮肤和血清AGEs可全面反映组织细胞糖基化。

Objective To investigate the relationship between skin and serum advanced glycation end products(AGEs),metabolic indexes and microvascular complications in patients with T2DM.Methods A total of 126 T2DM patients hospitalized in the Endocrinology and Metabolism Department of Yunnan First People's Hospital from were enrolled in this study from October 2017 to February 2018.According to non-dilation fundus photography,UACR and eGFR examination,enrolled patients were simple diabetes group(T2DM Group,n=42),combined with diabetic retinopathy(DR)or early diabetic kidney disease(DKD)group(DR/DKD Group,n=58)and DR combined with early DKD group(DR+DKD Group,n=26).We used skin autofluorescence and enzyme-linked immunosorbent assay to detect skin and serum AGEs,and analyze their correlation with sex,age,diabetes duration,glucose and lipid metabolism indexes.ResultsThe levels of AGEs in the skin of T2DM,DR/DKD,and DR+DKD groups increased sequentially[(75.16±12.64)vs(82.12±12.59)vs(92.48±8.96),P<0.05].The level of serum AGEs in DR+DKD group was higher than that in T2DM group and DR/DKD group[(22.97±5.46)vs(13.68±5.14)vs(14.28±4.47)μg/ml,P<0.05].Skin AGEs levels were positively correlated with age,FPG and LDL-C levels and negatively correlated with BMI(P<0.05);serum AGEs levels were positively correlated with HbA_1c and LDL-C levels(P<0.05).ConclusionSkin and serum AGEs levels are associated with metabolic indicators and diabetic microvascular complications in T2DM patients.The combined detection of the two methods may reflect the glycosylation more comprehensively in tissue cells in the body.