Nayak Shivananda B, Bhaktha Geetha
Department of Biochemistry, Kasturba Medical College, Manipal-576104, India.
Lipids Health Dis. 2005 Aug 10;4:15. doi: 10.1186/1476-511X-4-15.
Plasma sialic acid is a marker of the acute phase response. Objective is to study the relationship between sialic acid relationship with metabolic variables in Indian type 2 diabetes with and without microvascular complications.
Fasting Venous blood samples were taken from 200 subjects of which 50 were of diabetes mellitus (DM) and nephropathy patients, 50 patients with type 2 diabetes and retinopathy, 50 patients with type 2 diabetes without any complications and 50 healthy individuals without diabetes. The Indian subject's aged 15-60 years with type 2 diabetes were recruited for the study. Simultaneously urine samples were also collected from each of the subjects. All the blood samples were analyzed for total cholesterol, triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting and postprandial glucose on fully automated analyzer. Serum and urine sialic acid along with microalbumin levels were also estimated.
There was a significantly increasing trend of plasma and urine sialic acid with severity of nephropathy (P < 0.001) and with degree of urinary albumin excretion (P < 0.001). Serum sialic acid correlated with increasing serum creatinine concentration (P < 0.001). Elevated serum sialic acid concentrations were also associated with several risk factors for diabetic vascular disease: diabetes duration, HbA1c, serum triglyceride and cholesterol concentrations, waist-to-hip ratio and hypertension. Significant correlations were found between sialic acid concentration and cardiovascular risk factors like LDL and TG in the diabetic subjects.
The main finding of this study is that elevated serum and urinary sialic acid and microalbumin concentrations were strongly related to the presence of microvascular complications like diabetic nephropathy and retinopathy and cardiovascular risk factors in Indian type 2 diabetic subjects. Further study of acute-phase response markers and mediators as indicators or predictors of diabetic microvascular complications is therefore justified.
血浆唾液酸是急性期反应的一个标志物。目的是研究印度2型糖尿病患者有无微血管并发症时唾液酸与代谢变量之间的关系。
从200名受试者中采集空腹静脉血样本,其中50名是糖尿病(DM)合并肾病患者,50名2型糖尿病合并视网膜病变患者,50名无任何并发症的2型糖尿病患者,以及50名无糖尿病的健康个体。招募年龄在15 - 60岁的印度2型糖尿病受试者进行该研究。同时,也从每个受试者采集尿液样本。所有血样在全自动分析仪上分析总胆固醇、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹和餐后血糖。还测定了血清和尿液中的唾液酸以及微量白蛋白水平。
血浆和尿液唾液酸水平随肾病严重程度(P < 0.001)以及尿白蛋白排泄程度(P < 0.001)呈显著上升趋势。血清唾液酸与血清肌酐浓度升高相关(P < 0.001)。血清唾液酸浓度升高还与糖尿病血管疾病的多个危险因素相关:糖尿病病程、糖化血红蛋白(HbA1c)、血清甘油三酯和胆固醇浓度、腰臀比以及高血压。在糖尿病受试者中,唾液酸浓度与心血管危险因素如LDL和TG之间存在显著相关性。
本研究的主要发现是,血清和尿液中唾液酸及微量白蛋白浓度升高与印度2型糖尿病患者微血管并发症如糖尿病肾病和视网膜病变以及心血管危险因素的存在密切相关。因此,进一步研究急性期反应标志物和介质作为糖尿病微血管并发症的指标或预测因子是合理的。