Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University Health System, Singapore, Singapore.
Diabetes Metab Syndr Obes. 2012;5:155-64. doi: 10.2147/DMSO.S32283. Epub 2012 Jun 29.
The main objective of this study was to investigate whether plasma pentosidine levels were associated with cataract and low estimated glomerular filtration rate (eGFR) in nonproteinuric type 2 diabetic patients.
We characterized 888 nonproteinuric type 2 diabetic patients residing in Singapore according to their eGFR values. Proteinuria was excluded on the basis of multiple urinalyses. Patients with low renal function (cases, n = 125) and controls (n = 763) were defined as having eGFR < and ≥60 mL/min/1.73 m(2), respectively. Pentosidine levels were measured by enzyme-linked immunosorbent assay. Multinomial logistic regression was used to test the association between plasma pentosidine levels and the joint phenotype of cataract and low eGFR.
Cases had higher triacylglycerol values, higher systolic blood pressure, and were more likely to be treated with two or more antihypertensive medications. In univariate analysis, cases were potentially more than twice as likely to have had a history of cataract compared with controls. This association persisted in multivariate analyses after adjusting for the significant covariates, hypertension and triacylglycerol, but was attenuated when age was included in the model. Plasma pentosidine levels were significantly higher in cases with low eGFR who also had a history of cataract. This association persisted in multivariate analyses that included the covariates, glycosylated hemoglobin, hypertension, and diabetic retinopathy, as well as age.
Carbonyl stress, as reflected by pentosidine levels, is present in a subset of nonproteinuric diabetic patients. Clinically, this stress was associated with the joint presence of cataract and low eGFR.
本研究的主要目的是探讨非蛋白尿 2 型糖尿病患者血浆戊糖素水平与白内障和低估计肾小球滤过率（eGFR）的关系。
我们根据 eGFR 值对 888 例居住在新加坡的非蛋白尿 2 型糖尿病患者进行了特征描述。基于多次尿液分析排除蛋白尿。将肾功能低下的患者（病例组，n=125）和对照组（n=763）定义为 eGFR<60 mL/min/1.73 m²和≥60 mL/min/1.73 m²。戊糖素水平通过酶联免疫吸附试验进行测量。多变量逻辑回归用于测试血浆戊糖素水平与白内障和低 eGFR 联合表型之间的关系。
病例组的三酰甘油值较高，收缩压较高，且更有可能接受两种或多种降压药物治疗。在单变量分析中，与对照组相比，病例组更有可能有白内障病史。在调整了显著协变量（高血压和三酰甘油）后，这种关联在多变量分析中仍然存在，但当年龄纳入模型时，这种关联减弱。患有低 eGFR 且有白内障病史的病例组的血浆戊糖素水平明显升高。这种关联在包括协变量（糖化血红蛋白、高血压和糖尿病视网膜病变）以及年龄的多变量分析中仍然存在。
羰基应激，如戊糖素水平所反映的，存在于一部分非蛋白尿糖尿病患者中。临床上，这种应激与白内障和低 eGFR 的共同存在有关。
