Iwasaki Tomoyuki, Togashi Yu, Terauchi Yasuo
Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Endocr J. 2008 May;55(2):311-6. doi: 10.1507/endocrj.k07-086. Epub 2008 Mar 7.
The aim of this study was to determine the association between serum albumin and the severity of microvascular complications and presence of coronary artery disease in type 2 diabetic patients.
The presence of diabetic complications was assessed in a total of 130 Japanese patients with type 2 diabetes mellitus. Retinopathy was classified as absent, simple or proliferative diabetic retinopathy. Neuropathy was considered to be present when the patient showed absence of Achilles tendon reflex, and also evaluated by measuring the median motor nerve conduction velocity (MNCV) in the nerve conduction study.
In relation to retinopathy, there were 83 patients with no retinopathy (absent), 26 with simple retinopathy and 21 with proliferative retinopathy. There was a significant difference in the serum albumin level between the "absent" group and the other two groups. In relation to nephropathy, there were 68 patients with no evidence of nephropathy, 49 with microalbuminuria and 13 with proteinuria. The results of logistic regression analysis with adjustment for three variables (age, gender, serum CRP) revealed that serum albumin was independently related to proliferative retinopathy and proteinuria. In relation to neuropathy, serum albumin was found to be significantly related to the absence of Achilles tendon reflex, MNCV, and MFWL. The results of multiple regression analysis with adjustment for three variables (age, gender, serum CRP) revealed that serum albumin was independently related to MNCV and MFWL.
Serum albumin was significantly associated with the severity of retinopathy and neuropathy.
本研究旨在确定2型糖尿病患者血清白蛋白与微血管并发症严重程度及冠状动脉疾病存在情况之间的关联。
对总共130例日本2型糖尿病患者的糖尿病并发症情况进行评估。视网膜病变分为无、单纯性或增殖性糖尿病视网膜病变。当患者跟腱反射消失时判定为存在神经病变,并通过在神经传导研究中测量正中运动神经传导速度(MNCV)进行评估。
关于视网膜病变,83例患者无视网膜病变(无),26例有单纯性视网膜病变,21例有增殖性视网膜病变。“无”组与其他两组之间血清白蛋白水平存在显著差异。关于肾病,68例患者无肾病证据,49例有微量白蛋白尿,13例有蛋白尿。对三个变量(年龄、性别、血清CRP)进行调整后的逻辑回归分析结果显示,血清白蛋白与增殖性视网膜病变和蛋白尿独立相关。关于神经病变,发现血清白蛋白与跟腱反射消失、MNCV和MFWL显著相关。对三个变量(年龄、性别、血清CRP)进行调整后的多元回归分析结果显示,血清白蛋白与MNCV和MFWL独立相关。
血清白蛋白与视网膜病变和神经病变的严重程度显著相关。