Piwowar Agnieszka, Knapik-Kordecka Maria, Warwas Maria
Department of Pharmaceutical Biochemistry of Wroclaw Medical University, Wrocław, Poland.
Dis Markers. 2008;24(6):311-7. doi: 10.1155/2008/784313.
The main goal of the present study was the evaluation of ischemia-modified albumin (IMA) in patients with type 2 diabetes mellitus and estimation of its connection with vascular complications, glycemic control, hypertension, dyslipidemia and obesity.
In 76 diabetic patients and 25 control subjects, a plasma level of IMA by manually performed, spectrophotometric Co(II)-albumin binding assay was determined. Other parameters such as glucose, fructosamine, HbA_{1c}, total cholesterol and its fractions (HDL, LDL), triglicerydes were estimated by routine methods.
Diabetic patients had significantly higher level of IMA in comparison with control subjects. There were not significant differences between groups with various states of vascular complications although the lowest concentration of IMA was observed in patients with microangiopathy. Patients with poor glycemic control had higher IMA level in comparison with these with good glycemic control. Significant correlation was observed between IMA and HbA_{1c}. Among the risk factors, only blood pressure and LDL showed a weak relationship with IMA level.
Our results revealed, for the first time, higher level of IMA in diabetic patients which confirms that it may be of non-cardiac origin. We can suggest that the albumin molecule in plasma of diabetic patients is modified in the chronic hypoxia conditions provoked mainly by hyperglycemia and oxidative stress in diabetes.
本研究的主要目的是评估2型糖尿病患者的缺血修饰白蛋白（IMA），并估计其与血管并发症、血糖控制、高血压、血脂异常和肥胖的关系。
对76例糖尿病患者和25例对照者，采用手工分光光度法钴（II）-白蛋白结合试验测定血浆IMA水平。通过常规方法评估其他参数，如血糖、果糖胺、糖化血红蛋白（HbA₁c）、总胆固醇及其组分（高密度脂蛋白、低密度脂蛋白）、甘油三酯。
与对照者相比，糖尿病患者的IMA水平显著更高。尽管微血管病变患者的IMA浓度最低，但不同血管并发症状态的组间差异不显著。血糖控制差的患者与血糖控制良好的患者相比，IMA水平更高。IMA与HbA₁c之间存在显著相关性。在危险因素中，只有血压和低密度脂蛋白与IMA水平呈弱相关。
我们的结果首次揭示糖尿病患者的IMA水平较高，这证实其可能并非源于心脏。我们可以推测，糖尿病患者血浆中的白蛋白分子在主要由高血糖和糖尿病氧化应激引发的慢性缺氧条件下发生了修饰。
