Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China.
Front Endocrinol (Lausanne). 2023 Mar 2;14:1117308. doi: 10.3389/fendo.2023.1117308. eCollection 2023.
Serum levels of amino acids related to urea cycle are associated with risk of type 2 diabetes mellitus (T2DM). Our study aimed to explore whether serum levels of amino acids related to urea cycle, i.e., arginine, citrulline, and ornithine, are also associated with increased risk of chronic kidney disease (CKD) in T2DM.
We extracted medical records of 1032 consecutive patients with T2DM from the Electronic Administrative System of Liaoning Medical University First Affiliated Hospital (LMUFAH) system from May 2015 to August 2016. Of them, 855 patients with completed data available were used in the analysis. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m. Serum amino acids were measured by mass spectrometry (MS) technology. Binary logistic regression was performed to obtain odds ratios (ORs) and their 95% confidence intervals (CIs).
52.3% of the 855 T2DM patients were male, and 143 had CKD. In univariable analysis, high serum citrulline, high ratio of arginine to ornithine, and low ratio of ornithine to citrulline were associated with markedly increased risk of CKD (OR of top vs. bottom tertile: 2.87, 95%CI, 1.79-4.62 & 1.98, 95%CI,1.25-3.14 & 2.56, 95%CI, 1.61-4.07, respectively). In multivariable analysis, the ORs of citrulline and ornithine/citrulline ratio for CKD remained significant (OR of top vs. bottom tertile: 2.22, 95%CI, 1.29-3.82 & 2.24, 1.29-3.87, respectively).
In Chinese patients with T2DM, high citrulline and low ornithine/citrulline ratio were associated with increased risk of CKD.
与尿素循环相关的氨基酸的血清水平与 2 型糖尿病（T2DM）的发病风险相关。本研究旨在探讨与尿素循环相关的氨基酸（精氨酸、瓜氨酸和鸟氨酸）的血清水平是否也与 T2DM 患者的慢性肾脏病（CKD）风险增加有关。
我们从 2015 年 5 月至 2016 年 8 月从辽宁医科大学第一附属医院电子行政系统（LMUFAH）系统中提取了 1032 例连续 T2DM 患者的病历。其中，有 855 例完成了数据可用的患者用于分析。CKD 的定义为估算肾小球滤过率（eGFR）<60 mL/min/1.73 m。采用质谱（MS）技术测定血清氨基酸。采用二项逻辑回归得到比值比（OR）及其 95%置信区间（CI）。
855 例 T2DM 患者中，52.3%为男性，143 例患有 CKD。在单变量分析中，高血清瓜氨酸、高精氨酸/鸟氨酸比值和低鸟氨酸/瓜氨酸比值与 CKD 的发病风险显著增加相关（最高与最低三分位比：2.87，95%CI，1.79-4.62 和 1.98，95%CI，1.25-3.14 和 2.56，95%CI，1.61-4.07）。多变量分析中，瓜氨酸和鸟氨酸/瓜氨酸比值的 OR 仍有意义（最高与最低三分位比：2.22，95%CI，1.29-3.82 和 2.24，95%CI，1.29-3.87）。
在中国 T2DM 患者中，高瓜氨酸和低鸟氨酸/瓜氨酸比值与 CKD 风险增加相关。
