Cao Yun-Feng, Li Jing, Zhang Zhipeng, Liu Jinnan, Sun Xiao-Yu, Feng Xiao-Fei, Luo Hui-Huan, Yang Wen, Li Sai-Nan, Yang Xilin, Fang Zhong-Ze
Key Laboratory of Contraceptives and Devices Research (NPFPC), Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Front Endocrinol (Lausanne). 2019 Feb 18;10:50. doi: 10.3389/fendo.2019.00050. eCollection 2019.
This study aimed to test associations between type 2 diabetes mellitus (T2DM) and metabolites in urea cycle including arginine, citrulline and ornithine. This study used a hospital-based cross-sectional study design. We retrieved medical notes of 401 in-patients with onset of T2DM within 2 years and 1,522 healthy subjects who attended annual physical examination. All cases were admitted to a tertiary care center in Jinzhou, China from May 2015 to August 2016. Binary logistic regression analyses were performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Patients with T2DM had higher arginine, and lower ornithine than control subjects. Levels of citrulline were similar in two groups. Arginine was positively associated with T2DM (ORs: 1.20, 1.17-1.23) while ornithine was negatively associated with T2DM (OR: 0.89, 0.88-0.91). After adjustment for other amino acids and traditional risk factors, these associations were still significant and persistent for arginine and ornithine. The association between citrulline and T2DM was not significant. Their ratios of pairs of two amino acids were associated with increased risk of T2DM. After adjustment for other ratios of amino acids, effect size for T2DM remained significant. Further adjustment for traditional risk factors did not lead to large changes (ORs: 1.78, 1.20-2.65 for the ratio of arginine to ornithine; ORs: 1.59, 1.37-1.86 for the ratio of citrulline to ornithine, respectively) except the ratio of arginine to citrulline. Plasma levels of amino acids related to urea cycle and their ratios of these amino-acids were associated with T2DM in Chinese adults.
本研究旨在测试2型糖尿病（T2DM）与尿素循环中的代谢物（包括精氨酸、瓜氨酸和鸟氨酸）之间的关联。本研究采用基于医院的横断面研究设计。我们检索了401例发病2年内的T2DM住院患者以及1522例参加年度体检的健康受试者的病历。所有病例均于2015年5月至2016年8月在中国锦州的一家三级医疗中心就诊。进行二元逻辑回归分析以获得比值比（OR）和95%置信区间（CI）。T2DM患者的精氨酸水平高于对照组，而鸟氨酸水平低于对照组。两组的瓜氨酸水平相似。精氨酸与T2DM呈正相关（OR：1.20，1.17 - 1.23），而鸟氨酸与T2DM呈负相关（OR：0.89，0.88 - 0.91）。在调整其他氨基酸和传统危险因素后，精氨酸和鸟氨酸的这些关联仍然显著且持续存在。瓜氨酸与T2DM之间的关联不显著。两种氨基酸的比值与T2DM风险增加相关。在调整其他氨基酸比值后，T2DM的效应量仍然显著。进一步调整传统危险因素除精氨酸与瓜氨酸的比值外未导致大的变化（精氨酸与鸟氨酸比值的OR：1.78，1.20 - 2.65；瓜氨酸与鸟氨酸比值的OR：1.59，1.37 - 1.86）。在中国成年人中，与尿素循环相关的血浆氨基酸水平及其氨基酸比值与T2DM相关。
