Gomes Marília B, Nogueira Verônica G
Unit of Diabetes, Department of Medicine, State University Hospital of Rio de Janeiro, Estrada Barra, 1006 bl. 3/502, Rio de Janeiro 22648-900, Brazil.
Diabetes Res Clin Pract. 2004 Oct;66(1):31-9. doi: 10.1016/j.diabres.2004.02.009.
to determine the relationship between acute-phase proteins and microalbuminuria in type 2 diabetic patients without clinical evidence of macrovascular disease.
We studied cross-sectionally 64 non-smoking outpatients with type 2 diabetes mellitus without clinical evidence of cardiovascular disease attended at Brazilian University General Hospital aged 59.5 +/- 8.1 years and with a known duration of diabetes of 11.5 +/- 8 years. Urinary albumin excretion rate (AER) was determined in timed overnight urine samples. Serum alpha(1)-acid glycoprotein (AGP) and plasma fibrinogen were determined by immunoturbidimetry assay and serum C-reactive protein (CRP) was measured by a high-sensitive immunonephelometry assay.
A higher levels of AGP (P = 0.0000), CRP (P= 0.003) and fibrinogen ( P = 0.0001) were found in microalbuminuric (n = 26) than in normoalbuminuric patients ( n = 38). All the acute-phase proteins were correlated with each other and with AER, respectively (r = 0.67 for AGP; 0.35 for fibrinogen, and 0.41 for CRP, P < 0.01 for all). Stepwise multiple regression analysis showed that AGP was independently associated with AER along with systolic blood pressure (r2 = 0.49, P = 0.000). Logistic regression analysis showed that AGP was independently related to microalbuminuria with an odds ratio (95% CI) of 1.16 ((1.08-1.24), P = 0.000).
According to our results acute-phase proteins a known markers of chronic inflammation were associated with microalbuminuria independently of clinical cardiovascular disease. The influence of AGP on AER and microalbuminuria needs to be confirmed in prospective studies. Intervention studies are necessary to assess whether anti-inflammatory treatment would have a beneficial effect on this chronic complication of diabetes.
确定无大血管疾病临床证据的2型糖尿病患者中急性期蛋白与微量白蛋白尿之间的关系。
我们对巴西大学总医院64例无心血管疾病临床证据的非吸烟2型糖尿病门诊患者进行了横断面研究，患者年龄为59.5±8.1岁，已知糖尿病病程为11.5±8年。通过定时过夜尿液样本测定尿白蛋白排泄率（AER）。血清α1-酸性糖蛋白（AGP）和血浆纤维蛋白原采用免疫比浊法测定，血清C反应蛋白（CRP）采用高敏免疫比浊法测定。
微量白蛋白尿患者（n = 26）的AGP（P = 0.0000）、CRP（P = 0.003）和纤维蛋白原（P = 0.0001）水平高于正常白蛋白尿患者（n = 38）。所有急性期蛋白彼此之间以及与AER均分别相关（AGP的r = 0.67；纤维蛋白原的r = 0.35，CRP的r = 0.41，P均<0.01）。逐步多元回归分析显示，AGP与AER以及收缩压独立相关（r2 = 0.49，P = 0.000）。逻辑回归分析显示，AGP与微量白蛋白尿独立相关，比值比（95%CI）为1.16（（1.08 - 1.24），P = 0.000）。
根据我们的结果，作为慢性炎症已知标志物的急性期蛋白与微量白蛋白尿相关，且独立于临床心血管疾病。AGP对AER和微量白蛋白尿的影响需要在前瞻性研究中得到证实。有必要进行干预研究以评估抗炎治疗是否会对糖尿病的这种慢性并发症产生有益影响。
