ADMA 是早期糖尿病胰岛素抵抗的一个相关指标，与 hs-CRP 和身体肥胖无关。

ADMA is a correlate of insulin resistance in early-stage diabetes independent of hs-CRP and body adiposity.

机构信息

Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, P.O Box 13145-784, Tehran, Iran.

出版信息

Ann Endocrinol (Paris). 2010 Sep;71(4):303-8. doi: 10.1016/j.ando.2010.02.026.

DOI:10.1016/j.ando.2010.02.026

PMID:20434720

Abstract

OBJECTIVES

It has been shown that insulin resistance is associated with a state of chronic low-grade inflammation. Furthermore, depletion of nitric oxide (NO) or ineffectiveness of NO-mediated vasodilator mechanisms are associated with arterial stiffness and progression of insulin resistance to type-2 diabetes. In this study, we decided to evaluate the association between asymmetric dimethylarginine ([ADMA], an endogenous NO synthase inhibitor), high-sensitivity C-reactive protein ([hs-CRP]; a marker of chronic inflammation) and insulin resistance in early-stage type-2 diabetes.

METHODS

A total of 40 diabetic patients and 40 age-, sex- and body mass index (BMI)-matched healthy adult volunteers were recruited in this case-control study. Diabetic patients were recently diagnosed and did not have a history of any diabetes-related complications. Fasting blood samples were obtained and fasting plasma glucose, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, creatinine, insulin, ADMA and hs-CRP were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) was also calculated.

RESULTS

ADMA (0.9+/-0.2 vs 0.7+/-0.2 micromol/L; p<0.001) and hs-CRP (3.0+/-2.1 vs 1.3+/-1.0mg/L; p<0.001) were significantly higher in diabetic participants vs healthy controls. Age- and sex-adjusted ADMA values were significantly (p<0.05) correlated with hs-CRP (r=0.279) and HOMA-IR (r=0.288) in diabetic patients. These associations were not significant in healthy controls. The association between ADMA and HOMA-IR in diabetic patients remained significant (r=0.255; p<0.05), after adjustment for BMI, waist circumference, serum lipids, and hs-CRP. In multivariate regression analysis, ADMA and hs-CRP were independently correlated with diabetes.

CONCLUSION

In early-stage type-2 diabetic patients, ADMA is an independent predictor of insulin resistance. Our results could possibly point to an independent mechanism for contribution of ADMA in development of insulin resistance.

摘要

目的

已有研究表明胰岛素抵抗与慢性低度炎症状态有关。此外，一氧化氮（NO）耗竭或 NO 介导的血管舒张机制失效与动脉僵硬和胰岛素抵抗向 2 型糖尿病的进展有关。在这项研究中，我们决定评估内源性一氧化氮合酶抑制剂不对称二甲基精氨酸 ([ADMA])、高敏 C 反应蛋白 ([hs-CRP]；慢性炎症标志物)与 2 型糖尿病早期胰岛素抵抗之间的关系。

方法

本病例对照研究共纳入 40 例糖尿病患者和 40 名年龄、性别和体重指数 (BMI) 匹配的健康成年志愿者。糖尿病患者为近期诊断且无任何糖尿病相关并发症史。采集空腹血样，检测空腹血糖、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、肌酐、胰岛素、ADMA 和 hs-CRP。还计算了稳态模型评估的胰岛素抵抗 (HOMA-IR)。

结果

与健康对照组相比，糖尿病患者的 ADMA（0.9±0.2 对 0.7±0.2 μmol/L；p<0.001）和 hs-CRP（3.0±2.1 对 1.3±1.0mg/L；p<0.001）显著升高。在糖尿病患者中，年龄和性别校正后的 ADMA 值与 hs-CRP（r=0.279）和 HOMA-IR（r=0.288）显著相关（p<0.05）。在健康对照组中，这些相关性不显著。在调整 BMI、腰围、血脂和 hs-CRP 后，糖尿病患者 ADMA 与 HOMA-IR 之间的关联仍然显著（r=0.255；p<0.05）。多元回归分析显示，ADMA 和 hs-CRP 与糖尿病独立相关。