Ono Mitsutaka, Takebe Noriko, Oda Tomoyasu, Nakagawa Riyuki, Matsui Mizue, Sasai Takayoshi, Nagasawa Kan, Honma Hiroyuki, Kajiwara Takashi, Taneichi Haruhito, Takahashi Yoshihiko, Takahashi Kazuma, Satoh Jo
Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan.
Intern Med. 2014;53(5):391-6. doi: 10.2169/internalmedicine.53.9549.
Oxidative stress has been implicated in the development of coronary artery calcification (CAC). However, there are few reports on this issue in Japanese patients with diabetes. In this study, we examined the association of the CAC score (CACS) with oxidative stress markers.
The study subjects were 163 Japanese patients with type 2 diabetes (75 men and 88 women). The CACS (Agatston unit: AU) was measured by multi-detector computed tomography (MDCT), and the oxidative stress markers, such as the urinary 8-isoprostane and 8-hydroxydeoxyguanosine (8-OHdG) and serum malondialdehyde (MDA)-LDL cholesterol were measured. The relationships between CACS and oxidative stress markers were statistically analyzed.
Compared with the CACS 0-400 AU group (n=132), the age, duration of diabetes, urinary 8-isoprostane levels, serum MDA-LDL-C/LDL-C and maximum intima media thickness (IMT) were higher, and body mass index and HbA1c level were lower, in the CACS >400 AU group (n=31). The multiple logistic regression analysis showed that a CAC >400 AU was independently associated with the urinary 8-isoprostane (>median) (OR=2.54, 95% CI=1.03-6.32, p=0.044), MDA-LDL-C/LDL-C (>median) (OR=2.62, 95% CI=1.07-6.40, p=0.035) and HbA1c (>median) (OR=0.32, CI=0.12-0.87, p<0.025). Focusing on oxidative stress, a higher MDA-LDL-C/LDL-C (p=0.026) and a higher urinary 8-isoprostane level (p=0.074) were associated with the CACS.
The CACS was found to be independently associated with the MDA-LDL-C/LDL-C and urinary 8-isoprostane levels in Japanese patients with type 2 diabetes.
氧化应激与冠状动脉钙化(CAC)的发生有关。然而,关于日本糖尿病患者这一问题的报道较少。在本研究中,我们检测了CAC评分(CACS)与氧化应激标志物之间的关联。
研究对象为163例日本2型糖尿病患者(75例男性和88例女性)。通过多排螺旋计算机断层扫描(MDCT)测量CACS(阿加特斯顿单位:AU),并检测氧化应激标志物,如尿8-异前列腺素、8-羟基脱氧鸟苷(8-OHdG)以及血清丙二醛(MDA)-低密度脂蛋白胆固醇。对CACS与氧化应激标志物之间的关系进行统计学分析。
与CACS 0 - 400 AU组(n = 132)相比,CACS>400 AU组(n = 31)的年龄、糖尿病病程、尿8-异前列腺素水平、血清MDA-LDL-C/LDL-C以及最大内膜中层厚度(IMT)更高,而体重指数和糖化血红蛋白(HbA1c)水平更低。多因素逻辑回归分析显示,CACS>400 AU与尿8-异前列腺素(>中位数)(OR = 2.54,95%CI = 1.03 - 6.32,p = 0.044)、MDA-LDL-C/LDL-C(>中位数)(OR = 2.62,95%CI = 1.07 - 6.40,p = 0.035)以及HbA1c(>中位数)(OR = 0.32,CI = 0.12 - 0.87,p<0.025)独立相关。聚焦于氧化应激,较高的MDA-LDL-C/LDL-C(p = 0.026)和较高的尿8-异前列腺素水平(p = 0.074)与CACS相关。
在日本2型糖尿病患者中,发现CACS与MDA-LDL-C/LDL-C以及尿8-异前列腺素水平独立相关。