Urinary PGDS levels are associated with vascular injury in type 2 diabetes patients.
Urinary PGDS levels are associated with vascular injury in type 2 diabetes patients.
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DOI：
10.1016/j.diabres.2006.09.004
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发表时间：
2007-06
影响因子：
5.1
通讯作者：
R. Yoshikawa;J. Wada;K. Seiki;Takashi Matsuoka;S. Miyamoto;Kenji Takahashi;S. Ota;K. Taniai-
中科院分区：
文献类型：
--
作者：
R. Yoshikawa;J. Wada;K. Seiki;Takashi Matsuoka;S. Miyamoto;Kenji Takahashi;S. Ota;K. Taniai-
背景代谢综合征的存在已被证明是2型糖尿病患者心血管发病率和死亡率的预测因子。在一项横断面临床研究中，我们调查了代谢综合征与无症状腔隙性中风和心血管疾病（CVD）的关联，我们比较了其意义与尿蛋白markets.METHODSWe研究了日本2型糖尿病患者（n=233，男性=124，女性=109）。根据WHO和国际糖尿病联合会（IDF）标准诊断代谢综合征。记录心血管事件，并通过磁共振成像（MRI）评价无症状腔隙性病变。我们还检测了233例患者的尿白蛋白、IV型胶原、β2-微球蛋白（β 2 MG）、N-乙酰-β-D-氨基葡萄糖苷酶（NAG）和脂笼蛋白型前列腺素D合成酶（PGDS）水平。代谢综合征（WHO）与无症状性腔隙性病变显着相关（p=0.035，OR=2.854，CI 1.075-7.579），而代谢综合征（IDF）或尿液标志物与无症状性腔隙性病变的存在无关。代谢综合征和微量白蛋白尿与CVD无明显相关性，而β 2 MG、NAG和PGDS升高与CVD有明显相关性。通过以尿蛋白为自变量的logistic回归分析，PGDS排泄量增加与CVD病史独立相关（p=0.025，OR=3.847，CI 1.180-12.545）。尿PGDS分泌的升高与心血管事件密切相关，可能是代谢性疾病标准的补充或额外标志物。综合征
BACKGROUNDThe presence of metabolic syndrome has been shown to be predictors of cardiovascular morbidity and mortality in patients with type 2 diabetes. In a cross-sectional clinical study, we investigated the association of metabolic syndrome with asymptomatic lacunar strokes and cardiovascular disease (CVD) and we compared its significance with urinary protein markers.METHODSWe studied Japanese type 2 diabetes patients (n=233, men=124, women=109). The diagnosis of metabolic syndrome was made according to WHO and International Diabetes Federation (IDF) criteria. Cardiovascular events were recorded and asymptomatic lacunar lesions were evaluated with magnetic resonance imaging (MRI). We also measured urinary levels of albumin, type IV collagen, β2-microglobulin (β2MG), N-acetyl-β-d-glucosaminidase (NAG) and lipocalin-type prostaglandin D synthase (PGDS).RESULTSThe prevalence of metabolic syndrome is 31.3% (IDF) and 52% (WHO) in 233 patients and microalbuminuria was present in 62 subjects (26.6%). Metabolic syndrome (WHO) significantly associated with asymptomatic lacunar lesions (p=0.035, OR=2.854, CI 1.075–7.579), while metabolic syndrome (IDF) or urinary markers failed to associate with presence of asymptomatic lacunar lesions. The presence of metabolic syndrome or microalbuminuria did not show significant association with CVD; however, the elevation of β2MG, NAG and PGDS showed significant association with CVD. By a logistic regression analysis using urinary proteins as independent variables, the presence of higher PGDS excretion independently associated with history of CVD (p=0.025, OR=3.847, CI 1.180–12.545).CONCLUSIONSIn type 2 diabetes patients, the elevation of urinary PGDS secretion closely associated with cardiovascular events and may be a supplemental or additional marker to the criteria of metabolic syndrome.