Department of Internal Medicine, Zagazig University, Faculty of Medicine, Egypt.
Department of Internal Medicine, Zagazig University, Faculty of Medicine, Egypt.
J Diabetes Complications. 2019 Jul;33(7):495-499. doi: 10.1016/j.jdiacomp.2019.04.003. Epub 2019 Apr 14.
Renal podocalyxin is a marker for kidney diseases. Previous studies have shown the expression of serum podocalyxin (s-Podxl) in the endothelial cells of blood vessels. We aimed to investigate the association between s-podxl levels and peripheral arterial disease (PAD) in subjects with type 2 diabetes (T2DM).
Serum Podxl levels were analyzed in 69 subjects with normal glucose tolerance and PAD (NGT-PAD), 120 subjects with T2DM and PAD (D-PAD) and 36 subjects with T2DM without PAD (D-NPAD).
In D-PAD Patients, s-Podxl was significantly higher (17.67 ± 20.7 ng/mL) than in D-NPAD subjects (9.97 ± 5.34 ng/mL; P < 0.001). Subjects with NGT-PAD had significantly higher s-Podxl levels (15.34 ± 18.21 ng/mL), than D-NPAD patients (P < 0.001). Subjects with D-PAD and medial calcific sclerosis (MCS) had significantly higher s-Podxl levels compared to the same group but without MCS (P < 0.02). In D-PAD patients, MCS (P = 0.003) and glycosylated hemoglobin (P < 0.001) were the two variables that had the strongest prediction for s-Podxl as revealed by regression analysis. Multivariate regression showed that an increase of one standard deviation in s-Podxl was associated with an odds ratio of 3.4 (95% confidence interval = 2.2-4.6, P < 0.001) for the prevalence of PAD.
This is the first study showing an association between s-Podxl and PAD in patients with T2DM. S-Podxl was higher in D-PAD patients than in D-NPAD subjects. In NGT-PAD patients, s-Podxl was also higher than in D-NPAD patients. In patients with D-PAD, s-Podxl was positively associated with MCS.
足细胞 podocalyxin 是肾脏疾病的标志物。先前的研究表明，血清足细胞 podocalyxin（s-Podxl）在血管内皮细胞中有表达。我们旨在探讨 2 型糖尿病（T2DM）患者血清 podocalyxin （s-Podxl）水平与外周动脉疾病（PAD）之间的关系。
分析了 69 例糖耐量正常合并 PAD（NGT-PAD）、120 例 T2DM 合并 PAD（D-PAD）和 36 例 T2DM 无 PAD（D-NPAD）患者的血清 Podxl 水平。
D-PAD 患者 s-Podxl 明显高于 D-NPAD 患者（17.67±20.7ng/ml 比 9.97±5.34ng/ml；P＜0.001）。NGT-PAD 患者 s-Podxl 水平（15.34±18.21ng/ml）显著高于 D-NPAD 患者（P＜0.001）。D-PAD 伴中膜钙化患者 s-Podxl 水平明显高于无中膜钙化者（P＜0.02）。在 D-PAD 患者中，多元回归分析显示，中膜钙化（P=0.003）和糖化血红蛋白（P＜0.001）是 s-Podxl 最强的预测变量。多元回归分析显示，s-Podxl 每增加一个标准差，PAD 的患病率比值比（OR）为 3.4（95%可信区间 2.2-4.6，P＜0.001）。
这是第一项研究表明，在 T2DM 患者中 s-Podxl 与 PAD 之间存在关联。D-PAD 患者 s-Podxl 高于 D-NPAD 患者。在 NGT-PAD 患者中，s-Podxl 也高于 D-NPAD 患者。在 D-PAD 患者中，s-Podxl 与中膜钙化呈正相关。
