Balamir Ilhan, Ates Ihsan, Topcuoglu Canan, Turhan Turan
1 Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
2 Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Angiology. 2018 Aug;69(7):609-616. doi: 10.1177/0003319717740781. Epub 2017 Nov 26.
We investigated the relationship of ischemia-modified albumin (IMA) and high-sensitivity C-reactive protein (hsCRP) levels with direct (endocan) and indirect (carotid intima-media thickness [cIMT] and 24 hours urine protein excretion) endothelial dysfunction indicators in type 2 diabetes mellitus (T2DM). Patients with T2DM (n = 88) and 88 healthy individuals were included in the study. The median endocan (475.15 vs 216.37 pg/mL; P < .001, respectively) and hsCRP (10.74 vs 3.11 mg/L; P < .001, respectively) and the mean IMA (0.64 ± 0.12 vs 0.51 ± 0.12 absorbance units; P < .001, respectively) levels were higher in participants with endothelial dysfunction compared to those without endothelial dysfunction in T2DM. The 24-hour urine protein excretion and cIMT levels had a positive correlation with hsCRP ( r = .357; P = .001 and r = .592; P < .001, respectively), IMA ( r = .519; P < .001 and r = .495; P < .001, respectively) and endocan ( r = .347; P = .001 and r = .583; P < .001, respectively) levels in the T2DM group. Stepwise multivariable logistic regression analysis, which included laboratory findings found to be associated with endothelial dysfunction, showed that endocan (odds ratio [OR] = 1.456; P = .004), hsCRP (OR = 1.298; P = .008), and IMA (OR = 2.270, P = .003) were independent risk factors. It was found that none of these markers were superior in terms of diagnostic discrimination for endothelial dysfunction. Endocan, IMA, and hsCRP levels were found to be associated with endothelial dysfunction in patients with T2DM.
我们研究了2型糖尿病(T2DM)患者中缺血修饰白蛋白(IMA)和高敏C反应蛋白(hsCRP)水平与直接(内皮糖蛋白)和间接(颈动脉内膜中层厚度[cIMT]及24小时尿蛋白排泄量)内皮功能障碍指标之间的关系。本研究纳入了88例T2DM患者和88名健康个体。与T2DM中无内皮功能障碍的参与者相比,有内皮功能障碍的参与者的内皮糖蛋白中位数(分别为475.15 vs 216.37 pg/mL;P < 0.001)、hsCRP中位数(分别为10.74 vs 3.11 mg/L;P < 0.001)以及IMA均值(分别为0.64±0.12 vs 0.51±0.12吸光度单位;P < 0.001)均更高。在T2DM组中,24小时尿蛋白排泄量和cIMT水平与hsCRP(r = 0.357;P = 0.001和r = 0.592;P < 0.001,分别)、IMA(r = 0.519;P < 0.001和r = 0.495;P < 0.001,分别)以及内皮糖蛋白(r = 0.347;P = 0.001和r = 0.583;P < 0.001,分别)水平呈正相关。逐步多变量逻辑回归分析纳入了发现与内皮功能障碍相关的实验室检查结果,结果显示内皮糖蛋白(比值比[OR] = 1.456;P = 0.004)、hsCRP(OR = 1.298;P = 0.008)和IMA(OR = 2.270,P = 0.003)是独立危险因素。结果发现,就内皮功能障碍的诊断鉴别而言,这些标志物均无优势。研究发现,内皮糖蛋白、IMA和hsCRP水平与T2DM患者的内皮功能障碍相关。