Canakkale Onsekiz Mart Universitesi, Tip Fakultesi, Endokrinoloji ve Metabolizma Hastaliklari BD, 17100 Çanakkale, Turkey.
Endocrine. 2009 Dec;36(3):425-32. doi: 10.1007/s12020-009-9236-5. Epub 2009 Sep 26.
Ischemia-modified albumin (IMA) is a novel marker of tissue ischemia. Nowadays, IMA is accepted as a marker of oxidative stress. In this study, we aimed at establishing an association between IMA and hyperglycemia, blood pressure, lipid parameters, microvascular complications, hsCRP, and microalbuminuria in type 2 diabetes patients without overt macrovascular disease and acute ischemia. Fifty type 2 diabetes mellitus patients without a history of macrovascular disease or end-stage renal disease were enrolled into the study. Age-matched 30 healthy individuals were also included in the study as a control group. Plasma IMA (0.329 ± 0.046 and 0.265 ± 0.045 AbsU; P < 0.0001) and hsCRP levels (0.51 ± 0.36 and 0.32 ± 0.17 mg/dl; P < 0.0001) were significantly higher in the diabetic group compared to healthy controls. IMA level was significantly correlated with hsCRP (r = 0.76; P < 0.0001), HbA1c (r = 0.72; P < 0.0001), microalbuminuria (r = 0.40; P = 0.004), systolic blood pressure (r = 0.28; P = 0.049), diastolic blood pressure (r = 0.44; P = 0.005), and HOMA-IR (r = 0.42; P = 0.005) levels in the entire diabetic subjects. In the diabetic patients group, presence of microalbuminuria was associated with a higher plasma IMA level (0.355 ± 0.035 and 0.265 ± 0.0045 AbsU; P < 0.0001, patients with microalbuminuria and control subjects, respectively). In the type 2 diabetes patients with nephropathy, IMA level (0.355 ± 0.035 and 0.311 ± 0.046 AbsU; P = 0.002) was determined higher compared to the diabetes patients without nephropathy. Diabetic patients without an overt cardiovascular disease still have a higher serum IMA level compared to healthy controls. The correlation of high plasma IMA levels with high hsCRP and microalbuminuria levels in diabetic subjects indicates the presence of a chronic ischemic process. Therefore, elevated IMA levels may indicate an underlying subclinical vascular disease in type 2 diabetes mellitus patients.
缺血修饰白蛋白（IMA）是一种组织缺血的新型标志物。如今，IMA 被认为是氧化应激的标志物。在这项研究中，我们旨在建立 IMA 与 2 型糖尿病患者无显性大血管疾病和急性缺血患者的高血糖、血压、血脂参数、微血管并发症、hsCRP 和微量白蛋白尿之间的关系。50 名无大血管疾病或终末期肾病史的 2 型糖尿病患者被纳入研究。还纳入了 30 名年龄匹配的健康个体作为对照组。与健康对照组相比，糖尿病组的血浆 IMA（0.329±0.046 和 0.265±0.045 AbsU；P<0.0001）和 hsCRP 水平（0.51±0.36 和 0.32±0.17 mg/dl；P<0.0001）显著升高。IMA 水平与 hsCRP（r=0.76；P<0.0001）、HbA1c（r=0.72；P<0.0001）、微量白蛋白尿（r=0.40；P=0.004）、收缩压（r=0.28；P=0.049）、舒张压（r=0.44；P=0.005）和 HOMA-IR（r=0.42；P=0.005）在整个糖尿病患者中均呈显著相关。在糖尿病患者组中，微量白蛋白尿患者的血浆 IMA 水平较高（0.355±0.035 和 0.265±0.0045 AbsU；P<0.0001，分别为微量白蛋白尿患者和对照组）。在有肾病的 2 型糖尿病患者中，IMA 水平（0.355±0.035 和 0.311±0.046 AbsU；P=0.002）高于无肾病的糖尿病患者。无显性心血管疾病的糖尿病患者的血清 IMA 水平仍高于健康对照组。高血浆 IMA 水平与糖尿病患者的高 hsCRP 和微量白蛋白尿水平相关，表明存在慢性缺血过程。因此，升高的 IMA 水平可能表明 2 型糖尿病患者存在潜在的亚临床血管疾病。
