Crook M A, Tutt P, Pickup J C
Division of Chemical Pathology, United Medical School, Guy's Hospital, London, United Kingdom.
Diabetes Care. 1993 Jan;16(1):57-60. doi: 10.2337/diacare.16.1.57.
In view of the possible link between serum sialic acid and cardiovascular disease in the general population, we investigated whether serum total and lipid-associated sialic concentrations are elevated in NIDDM patients compared with normal subjects. We also investigated how sialic acid levels relate to glycemic control, blood pressure, microalbuminuria, retinopathy, and serum lipid levels.
We selected 20 NIDDM patients at random and matched them for age and sex with 20 normal subjects. The patients also had a similar BMI as the control subjects. A first morning blood sample was taken for sialic acid, glucose, fructosamine, and lipid analysis, as was a first morning urine sample for assessment of microalbuminuria. Retinopathy was assessed by fundoscopy.
Both total and lipid-associated sialic acid levels were elevated in the NIDDM patients compared with control subjects (mean +/- SD, total: 0.74 +/- 0.11 vs. 0.60 +/- 0.22 g/L, P < 0.02; lipid-associated: 0.18 +/- 0.04 vs 0.12 +/- 0.04 g/L, P < 0.001). Total serum sialic acid was correlated with systolic blood pressure (r = 0.58, P < 0.01) and diastolic blood pressure (r = 0.58, P < 0.02). There was no significant relationship of total sialic acid with age, duration of diabetes, BMI, microalbuminuria, serum triglyceride, blood glucose, or serum fructosamine. A relationship of lipid-associated sialic acid levels and systolic blood pressure did not reach significance (P = 0.09). In 9 patients with background retinopathy with or without maculopathy, the total serum sialic acid concentration was higher than in those without retinopathy (0.81 +/- 0.09 vs. 0.69 +/- 0.10 g/L, P < 0.008). Lipid-associated sialic acid levels were similar in those with and without retinopathy. (The conversion factor for standard units to SI units is 1 gL = 3.2 mM.)
Total serum sialic acid levels were significantly elevated in a relatively small group of NIDDM patients and were correlated with hypertension and retinopathy. A larger study of circulating sialic acid concentrations as a risk factor for the development or marker of diabetic angiopathy is therefore justified.
鉴于普通人群中血清唾液酸与心血管疾病之间可能存在的联系，我们研究了与正常受试者相比，非胰岛素依赖型糖尿病（NIDDM）患者的血清总唾液酸和脂质相关唾液酸浓度是否升高。我们还研究了唾液酸水平与血糖控制、血压、微量白蛋白尿、视网膜病变及血清脂质水平之间的关系。
我们随机选取20例NIDDM患者，并按照年龄和性别与20名正常受试者进行匹配。患者的体重指数（BMI）也与对照受试者相似。采集清晨首次晨尿样本用于评估微量白蛋白尿，同时采集清晨首次血样用于唾液酸、葡萄糖、果糖胺及脂质分析。通过眼底镜检查评估视网膜病变情况。
与对照受试者相比，NIDDM患者的总唾液酸水平和脂质相关唾液酸水平均升高（均值±标准差，总唾液酸：0.74±0.11 vs. 0.60±0.22 g/L，P<0.02；脂质相关唾液酸：0.18±0.04 vs 0.12±0.04 g/L，P<0.001）。血清总唾液酸与收缩压（r = 0.58，P<0.01）和舒张压（r = 0.58，P<0.02）相关。总唾液酸与年龄、糖尿病病程、BMI、微量白蛋白尿、血清甘油三酯、血糖或血清果糖胺之间无显著关系。脂质相关唾液酸水平与收缩压的关系未达到显著水平（P = 0.09）。在9例有或无黄斑病变的背景性视网膜病变患者中，血清总唾液酸浓度高于无视网膜病变者（0.81±0.09 vs. 0.69±0.10 g/L，P<0.008）。有视网膜病变和无视网膜病变者的脂质相关唾液酸水平相似。（标准单位换算为国际单位的转换因子为1 g/L = 3.2 mM）。
在相对少量的NIDDM患者中，血清总唾液酸水平显著升高，且与高血压和视网膜病变相关。因此，有必要开展一项关于循环唾液酸浓度作为糖尿病血管病变发生风险因素或标志物的更大规模研究。
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