I型胰岛素依赖型糖尿病患者血清血管紧张素转换酶活性增加：其与代谢控制及糖尿病并发症的关系。

Increased serum angiotensin converting enzyme activity in type I insulin-dependent diabetes mellitus: its relation to metabolic control and diabetic complications.

作者信息

Van Dyk D J, Erman A, Erman T, Chen-Gal B, Sulkes J, Boner G

机构信息

Institute of Nephrology and Hypertension, Beilinson Medical Center, Petach Tikwa, Tel Aviv, Israel.

出版信息

Eur J Clin Invest. 1994 Jul;24(7):463-7. doi: 10.1111/j.1365-2362.1994.tb02376.x.

DOI:10.1111/j.1365-2362.1994.tb02376.x

PMID:7957503

Abstract

Serum angiotensin-converting enzyme (ACE) was measured in 150 insulin-dependent diabetes mellitus (IDDM) patients and 72 healthy subjects by radioassay, using [3H]-hippuryl-glycyl-glycine as a substrate. Mean (SD) serum ACE activity in diabetic patients was 120 +/- 33 nmol ml-1 min-1 (range 46-215) and was significantly increased by 56% compared to control values (77 +/- 23 nmol ml-1 min-1, range 46-125, P < 0.001). ACE activity > 125 nmol ml-1 min-1 was observed in 60 of 150 IDDM patients. 96 IDDM patients were normoalbuminuric (< 22 mg 24 h-1) and 49 patients were micro- or macroalbuminuric (range 22-6010 mg 24 h-1). Micro- and macroalbuminuric IDDM patients were found to have significantly greater ACE activity values than normoalbuminuric patients (128 +/- 36 vs. 115 +/- 30 nmol ml-1 min-1, P = 0.025). Metabolically well-controlled IDDM patients (glycosylated haemoglobin < or = 8%) had lower ACE activity values than the patients with glycosylated haemoglobin greater than 8% (109 +/- 20 vs. 127 +/- 32 nmol ml-1 min-1, P < 0.02). A significant correlation between degree of metabolic control and ACE activity was found (r = 0.435, P < 0.001) so that an increase in one glycosylated quartile unit is accompanied by an increase in ACE activity of 10.5 nmol ml-1 min-1. Thus ACE activity in the serum of IDDM patients was increased by 56% in 40% of the patients. It was increased in IDDM patients without complications and in patients with retinopathy or nephropathy.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

采用放射免疫分析法，以[³H]-马尿酸基-甘氨酰-甘氨酸为底物，对150例胰岛素依赖型糖尿病（IDDM）患者和72名健康受试者的血清血管紧张素转换酶（ACE）进行了测定。糖尿病患者血清ACE活性的均值（标准差）为120±33 nmol·ml⁻¹·min⁻¹（范围46 - 215），与对照值（77±23 nmol·ml⁻¹·min⁻¹，范围46 - 125）相比显著升高了56%（P < 0.001）。150例IDDM患者中有60例ACE活性>125 nmol·ml⁻¹·min⁻¹。96例IDDM患者为正常白蛋白尿（<22 mg·24 h⁻¹），49例患者为微量或大量白蛋白尿（范围22 - 6010 mg·24 h⁻¹）。发现微量和大量白蛋白尿的IDDM患者的ACE活性值显著高于正常白蛋白尿患者（128±36与115±30 nmol·ml⁻¹·min⁻¹，P = 0.025）。代谢控制良好的IDDM患者（糖化血红蛋白≤8%）的ACE活性值低于糖化血红蛋白大于8%的患者（109±20与127±32 nmol·ml⁻¹·min⁻¹，P < 0.02）。发现代谢控制程度与ACE活性之间存在显著相关性（r = 0.435，P < 0.001），因此糖化四分位数单位每增加一个单位，ACE活性增加10.5 nmol·ml⁻¹·min⁻¹。因此，40%的IDDM患者血清中的ACE活性升高了56%。在无并发症的IDDM患者以及患有视网膜病变或肾病的患者中，ACE活性均升高。（摘要截取自250字）