2型糖尿病患者皮肤晚期糖基化终末产物和血清肌肽酶-1与糖尿病微血管并发症的关系研究  

Relationships of Skin AGEs and Serum CN-1 with Microvascular Complications in Type 2 Diabetes Mellitus

作　　者：杨光 徐新[1] 张宇[2] 许娟 蒋淑娟 夏莉[1] 张洋[3] 王贻坤[3] 李忠胜 章诗琪[1] YANG Guang;XU Xin;ZHANG Yu;XU Juan;JIANG Shujuan;XIA Li;ZHANG Yang;WANG Yikun;LI Zhongsheng;ZHANG Shiqi(Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Endocrinology,Chuzhou Integrated Traditional Chinese and Western Medicine Hospital,Chuzhou 239000,China;Department of Opto-Electronics Technology Research Centre,Hefei Institutes of Physical Science,Chinese Academy of Sciences,Hefei 230031,China)

机构地区：[1]安徽医科大学第一附属医院内分泌科,安徽省合肥市230022 [2]安徽省滁州市中西医结合医院内分泌科,239000 [3]中国科学院物质科学研究院光电子技术研究中心,安徽省合肥市230031

出　　处：《中国全科医学》2022年第9期1082-1087,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81900746)。

摘　　要：背景高血糖在糖尿病并发症发生、发展中起重要作用。尽管肌肽是晚期糖基化终末产物(AGEs)的潜在清除剂,但其在组织中的有效性受血清肌肽酶-1(CN-1)活性的限制。目前2型糖尿病患者皮肤AGEs与血清CN-1的相关性及其与糖尿病微血管并发症的关系尚未明确。目的探究2型糖尿病患者皮肤AGEs、血清CN-1与糖尿病微血管并发症的关系,以评估皮肤AGEs和血清CN-1预测糖尿病并发症的临床价值。方法选取2021年1—3月在安徽医科大学第一附属医院内分泌科住院的2型糖尿病患者134例为研究对象,收集患者的临床资料。采用Pearson相关分析和Spearman秩相关分析探究皮肤AGEs与血清CN-1的相关性,皮肤AGEs、血清CN-1分别与一般资料、糖尿病微血管并发症及其他疾病、实验室检查指标的相关性,采用多元线性回归分析探究皮肤AGEs、血清CN-1变化的影响因素。结果134例患者中糖尿病视网膜病变(DR)13例(9.7%)、糖尿病肾病(DN)38例(28.4%)、糖尿病周围神经病变(DPN)56例(41.8%)、糖尿病周围血管病变79例(59.0%),皮肤AGEs(80.2±10.6),血清CN-1(6.9±3.4)μg/L。相关性分析结果显示,性别、年龄、DR与皮肤AGEs呈正相关(P<0.05),估算肾小球滤过率(eGFR)、CN-1与皮肤AGEs呈负相关(P<0.05)。多元线性回归分析结果显示,性别(B=7.630)、年龄(B=0.408)、DR(B=7.183)是皮肤AGEs的影响因素(P<0.05)。相关性分析结果显示,年龄、舒张压(DBP)与血清CN-1呈正相关(P<0.05),皮肤AGEs与血清CN-1呈负相关(P<0.05)。结论皮肤AGEs、血清CN-1与大部分糖尿病微血管并发症(DN、DPN及糖尿病周围血管病变)间无明显相关关系;与血清CN-1不同,皮肤AGEs与DR存在相关性。Background Hyperglycemia plays a significant role in the development and progression of diabetic complications.While carnosine is a putative scavenger of advanced glycation end products(AGEs),its availability in tissue is limited by the activity of serum carnosinase-1(CN-1).So far,the correlations of skin AGEs and serum CN-1 concentration with type 2 diabetes mellitus(T2DM),and microvascular complications in T2DM are still unclear.Objective To investigate the relationships of skin AGEs,and serum CN-1 with microvascular complications in T2DM to evaluate the predictive values of skin AGEs and serum CN-1 for diabetic complications.Methods A total of 134 inpatients with T2DM were recruited from the Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University between January and March 2021.Their clinical data were collected.Pearson correlation analysis and Spearman rank correlation analysis were used to examine the correlation between skin AGEs and serum CN-1,and the correlations of skin AGEs and serum CN-1 with demographic and serological data,diabetic microvascular complications and other diseases.The influencing factors of skin AGEs and serum CN-1 were investigated by multiple linear regression analysis.Results Out of all subjects,there were 13(9.7%)cases of diabetic retinopathy(DR),38(28.4%)cases of diabetic nephropathy(DN),56(41.8%)cases of diabetic peripheral neuropathy(DPN),and 79(59.0%)cases of diabetic peripheral vascular disease.The skin AGEs level was(80.2±10.6)and serum CN-1 concentration was(6.9±3.4)μg/L on average.Correlation analyses demonstrated that gender,age,and DR were positively correlated with skin AGEs(P<0.05),but estimated glomerular filtration rate(eGFR)and CN-1 were negatively correlated with skin AGEs(P<0.05).Multiple linear regression analysis revealed that gender(B=7.630),age(B=0.408)and DR(B=7.183)were associated with skin AGEs(P<0.05).Correlation analyses showed that serum CN-1 was increased with age or with the increase in diastolic blood pressure(DBP)(P<0.05

关 键 词：糖尿病 2型 晚期糖基化终末产物 肌肽 肌肽酶-1 糖尿病肾病 糖尿病视网膜病变 糖尿病周围血管病变 

分 类 号：R587.1[医药卫生—内分泌]