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2 型糖尿病伴或不伴外周动脉疾病患者的缺血修饰白蛋白。

Ischemia-modified albumin in type 2 diabetic patients with and without peripheral arterial disease.

机构信息

Department of Endocrinology and Metabolism, Affiliated Huai'an Hospital, uzhou Medical College, Huai'an, China.

出版信息

Clinics (Sao Paulo). 2011;66(10):1677-80. doi: 10.1590/s1807-59322011001000003.

Abstract

OBJECTIVE

To determine whether there is an association between serum ischemia-modified albumin and the risk factor profile in type 2 diabetic patients with peripheral arterial disease and to identify the risk markers for peripheral arterial disease.

METHODS

Participants included 290 patients (35.2% women) with type 2 diabetes. The ankle-brachial pressure index was measured using a standard protocol, and peripheral arterial disease was defined as an ankle-brachial index <0.90 or >1.3. The basal ischemia-modified albumin levels and clinical parameters were measured and analyzed. The risk factors for peripheral arterial disease were examined by multiple logistic analyses.

RESULTS

Age, systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, urine albumin, homocysteine, and ischemia-modified albumin were significantly higher in patients with peripheral arterial disease than in disease-free patients (p<0.05), while ankle-brachial index was lower in the former group (p<0.05). Ischemia-modified albumin was positively associated with HbA1c and homocysteine levels (r = 0.220, p = 0.030; r = 0.446, p = 0.044, respectively), while no correlation was found with ankle-brachial index. Multiple logistic analyses indicated that HbA1c, systolic blood pressure, homocysteine and ischemia-modified albumin were independent risk factors for peripheral arterial disease in the diabetic subjects.

CONCLUSION

The baseline ischemia-modified albumin levels were significantly higher and positively associated with HbA1c and homocysteine levels in type 2 diabetic patients with peripheral arterial disease. Ischemia-modified albumin was a risk marker for peripheral arterial disease. Taken together, these results might be helpful for monitoring diabetic peripheral arterial disease.

摘要

目的

确定血清缺血修饰白蛋白(ischemia-modified albumin,IMA)与伴有外周动脉疾病(peripheral arterial disease,PAD)的 2 型糖尿病患者的危险因素谱之间是否存在关联,并确定 PAD 的风险标志物。

方法

纳入 290 例(35.2%为女性)2 型糖尿病患者。采用标准方案测量踝肱指数(ankle-brachial pressure index,ABI),ABI<0.90 或>1.3 定义为 PAD。测量并分析基础 IMA 水平和临床参数。采用多因素逻辑回归分析检查 PAD 的危险因素。

结果

与无 PAD 患者相比,有 PAD 的患者年龄、收缩压、总胆固醇、低密度脂蛋白胆固醇、尿白蛋白、同型半胱氨酸和 IMA 水平显著升高(p<0.05),ABI 则显著降低(p<0.05)。IMA 与 HbA1c 和同型半胱氨酸水平呈正相关(r = 0.220,p = 0.030;r = 0.446,p = 0.044),与 ABI 无相关性。多因素逻辑回归分析表明,HbA1c、收缩压、同型半胱氨酸和 IMA 是糖尿病患者 PAD 的独立危险因素。

结论

患有 PAD 的 2 型糖尿病患者的基础 IMA 水平显著升高,且与 HbA1c 和同型半胱氨酸水平呈正相关。IMA 是 PAD 的风险标志物。这些结果可能有助于监测糖尿病性 PAD。

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