Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Hypertension. 2010 Sep;56(3):471-6. doi: 10.1161/HYPERTENSIONAHA.110.156786. Epub 2010 Jul 19.
We test whether plasma level of methylglyoxal (MG) is an independent risk factor predicting the progression of diabetic macroangiopathy or microangiopathy in type 2 diabetic patients. We measured in 50 type 2 diabetic patients plasma levels of MG and 3-deoxyglucosone (DG) using an electrospray ionization-liquid chromatography-mass spectrometry. We assessed the correlations between baseline levels of MG or DG and the percentage changes after 5 years of clinical parameters linked to diabetic macroangiopathy or microangiopathy, that is, intima-media thickness (IMT), systolic blood pressure (SBP), the amount of urinary albumin excretion (ACR), pulse wave velocity (PWV), and estimated glomerular filtration rate (eGFR). Multiple regression analysis was performed using the percentage changes in IMT, SBP, ACR, PWV, and eGFR over the 5-year period as the independent or objective variables and the values of MG, DG, glycohemoglobin A1c, body mass index, triglyceride, and diabetic duration at the baseline as the dependent variables. The values of IMT, PWV, SBP, and ACR all increase, but eGFR reduces with time during the 5-year period. Baseline level of MG correlates significantly with the percentage changes of IMT, SBP, ACR, PWV, and eGFR, whereas that of DG does only with ACR. A multiple regression analysis reveals that MG is an independent risk factor for the percentage changes of IMT, PWV, and SBP but not for those of ACR and eGFR. DG is an independent risk factor for the percentage change of ACR. MG is a predictor in type 2 diabetic patients of intima-media thickening, of increase of PWV, and of elevation of SBP.
我们测试了血浆中甲基乙二醛(MG)水平是否为 2 型糖尿病患者糖尿病大血管或微血管病变进展的独立危险因素。我们使用电喷雾电离-液相色谱-质谱法测量了 50 例 2 型糖尿病患者的血浆 MG 和 3-脱氧葡萄糖酮(DG)水平。我们评估了基线时 MG 或 DG 水平与 5 年后与糖尿病大血管或微血管病变相关的临床参数的百分比变化之间的相关性,即内膜中层厚度(IMT)、收缩压(SBP)、尿白蛋白排泄量(ACR)、脉搏波速度(PWV)和估算肾小球滤过率(eGFR)。使用 IMT、SBP、ACR、PWV 和 eGFR 在 5 年内的百分比变化作为独立或客观变量,以及 MG、DG、糖化血红蛋白 A1c、体重指数、甘油三酯和糖尿病病程在基线时的值作为因变量,进行多元回归分析。在 5 年期间,IMT、PWV、SBP 和 ACR 的值增加,而 eGFR 减少。MG 水平与 IMT、SBP、ACR、PWV 和 eGFR 的百分比变化显著相关,而 DG 仅与 ACR 相关。多元回归分析显示,MG 是 IMT、PWV 和 SBP 百分比变化的独立危险因素,但不是 ACR 和 eGFR 百分比变化的独立危险因素。DG 是 ACR 百分比变化的独立危险因素。MG 是 2 型糖尿病患者内膜中层增厚、PWV 增加和 SBP 升高的预测因子。