Kalaria Tejaskumar R, Sirajwala Habibunnisha B, Gohel Mukesh G
The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
Government Medical College, Baroda, India.
J Diabetes Metab Disord. 2016 Nov 21;15:53. doi: 10.1186/s40200-016-0276-0. eCollection 2016.
Glycation of serum proteins has been proposed as an important mechanism of complications of diabetes but whether there are differences in glycation of different serum proteins and whether it has any correlation with development of microvascular complications has not been studied in depth. This study aimed to assess level of serum fructosamine, glycated albumin and glycated β-lipoprotein in type 2 diabetes mellitus patients with and without microvascular complications and to find out their correlation with diabetes complications.
Case-control study involving 150 individuals at a tertiary care hospital in western India. Fifty participants were healthy controls (group 1), 50 were type 2 diabetes patients without any evident microvascular complication (group 2) and 50 were type 2 diabetes patients with one or more microvascular complications (group 3). Serum fructosamine, FBS, PP2BS and other biochemical parameters were measured. Glycated albumin and glycated β-lipoprotein were measured by agarose gel electrophoresis followed by NBT staining. Unpaired -test was used to find out significance of difference between two groups and correlation coefficient to find out statistical correlation between two variables.
Type 2 diabetes patients with one or more microvascular complications had poor glycemic control as indicated by markers of short and mid-term glycemia. Differences between the groups for fructosamine, glycated albumin and glycated β-lipoprotein were significant ( < 0.001). Glycated albumin correlated with FBS, PP2BS and fructosamine in all diabetic patients (group 2 and 3) whereas glycated β-lipoprotein correlated with these parameters only in group 3 and it was markedly elevated in group 3.
Serum glycated β-lipoprotein was disproportionately elevated compared to fructosamine and glycated albumin in diabetes patients with microvascular complications (group 3) and it correlated with rest of glycemic markers only in this group. Glycated β-lipoprotein might help in identifying diabetic individuals at high future risk of developing microvascular complications.
血清蛋白糖基化被认为是糖尿病并发症的一个重要机制,但不同血清蛋白的糖基化是否存在差异以及它与微血管并发症的发生是否存在关联尚未得到深入研究。本研究旨在评估有无微血管并发症的2型糖尿病患者血清果糖胺、糖化白蛋白和糖化β脂蛋白水平,并找出它们与糖尿病并发症的相关性。
在印度西部一家三级护理医院对150名个体进行病例对照研究。50名参与者为健康对照(第1组),50名是无任何明显微血管并发症的2型糖尿病患者(第2组),50名是有一个或多个微血管并发症的2型糖尿病患者(第3组)。检测血清果糖胺、空腹血糖、餐后2小时血糖及其他生化参数。采用琼脂糖凝胶电泳结合NBT染色法检测糖化白蛋白和糖化β脂蛋白。采用非配对t检验来确定两组之间差异的显著性,并采用相关系数来确定两个变量之间的统计相关性。
有一个或多个微血管并发症的2型糖尿病患者的短期和中期血糖指标表明其血糖控制不佳。三组之间果糖胺、糖化白蛋白和糖化β脂蛋白的差异具有显著性(P<0.001)。在所有糖尿病患者(第2组和第3组)中,糖化白蛋白与空腹血糖、餐后2小时血糖和果糖胺相关,而糖化β脂蛋白仅在第3组与这些参数相关,且在第3组中显著升高。
在有微血管并发症的糖尿病患者(第3组)中,血清糖化β脂蛋白相比果糖胺和糖化白蛋白升高得更为明显,且仅在该组中与其他血糖指标相关。糖化β脂蛋白可能有助于识别未来发生微血管并发症风险较高的糖尿病个体。