Collier A, Rumley A, Rumley A G, Paterson J R, Leach J P, Lowe G D, Small M
Department of Clinical Chemistry, Gartnavel General Hospital, Glasgow, UK.
Diabetes. 1992 Aug;41(8):909-13. doi: 10.2337/diab.41.8.909.
In non-insulin-dependent diabetes mellitus (NIDDM) patients, microalbuminuria predicts early mortality, predominantly from cardiovascular disease. Increased free radical activity and abnormalities in hemostasis have been implicated in the development of vascular disease. Therefore, we measured markers of free radical activity (nonperoxide-conjugated diene isomer of linoleic acid [PL-9,11-LA'] and lipid peroxides expressed as malondialdehyde [MDA]) along with the hemostatic variables: fibrinogen, von Willebrand factor (vWf), plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (t-PA), and plasmin activity (B beta 15-42) in 24 NIDDM patients (12 patients with microalbuminuria and 12 without microalbuminuria) and in 12 age-matched control subjects. There were no differences in linoleic acid (PL-9,12-LA) concentrations between the three groups. PL-9,11-LA' was elevated in the microalbuminuric patients compared with control subjects (P less than 0.05), but there was no difference between the two diabetic groups. MDA was elevated in the microalbuminuric diabetic patients compared with those patients without microalbuminuria (P less than 0.05) and control subjects (P less than 0.001). MDA was also increased in the patients without microalbuminuria compared with control subjects (P less than 0.01). Except for B beta 15-42, all the hemostatic variables were increased (P less than 0.05) in the diabetic patients compared with control subjects. The microalbuminuric diabetic patients had further increases in vWf (P less than 0.03) and t-PA (P less than 0.03) compared with patients with microalbuminuria. Our study suggests that there is an increase in free radical activity and abnormalities in hemostatic variables favoring a hypercoagulable state in NIDDM, especially in those with microalbuminuria.(ABSTRACT TRUNCATED AT 250 WORDS)
在非胰岛素依赖型糖尿病（NIDDM）患者中，微量白蛋白尿可预测早期死亡率，主要是心血管疾病导致的死亡率。自由基活性增加和止血异常与血管疾病的发生有关。因此，我们检测了24例NIDDM患者（12例有微量白蛋白尿，12例无微量白蛋白尿）以及12例年龄匹配的对照者的自由基活性标志物（亚油酸的非过氧化物共轭二烯异构体[PL-9,11-LA']和以丙二醛[MDA]表示的脂质过氧化物）和止血变量：纤维蛋白原、血管性血友病因子（vWf）、纤溶酶原激活物抑制剂（PAI-1）、组织纤溶酶原激活物（t-PA）以及纤溶活性（Bβ15-42）。三组之间亚油酸（PL-9,12-LA）浓度无差异。与对照者相比，微量白蛋白尿患者的PL-9,11-LA'升高（P<0.05），但两个糖尿病组之间无差异。与无微量白蛋白尿的糖尿病患者（P<0.05）和对照者（P<0.001）相比，微量白蛋白尿糖尿病患者的MDA升高。与对照者相比，无微量白蛋白尿的患者MDA也升高（P<0.01）。与对照者相比，糖尿病患者除Bβ15-42外，所有止血变量均升高（P<0.05）。与无微量白蛋白尿的患者相比，微量白蛋白尿糖尿病患者的vWf（P<0.03）和t-PA（P<0.03）进一步升高。我们的研究表明，NIDDM患者尤其是有微量白蛋白尿的患者，自由基活性增加且止血变量异常，有利于高凝状态。（摘要截短至250字）
