Urinary sodium-to-potassium ratio and serum asymmetric dimethylarginine levels in patients with type 2 diabetes.
Urinary sodium-to-potassium ratio and serum asymmetric dimethylarginine levels in patients with type 2 diabetes.
复制标题
2 型糖尿病患者的尿钠钾比和血清不对称二甲基精氨酸水平。
DOI：
10.1038/s41440-018-0098-1
复制
发表时间：
2018
影响因子：
5.4
通讯作者：
Fukuo K.
中科院分区：
文献类型：
--
作者：
Yokoro M;Minami M;Okada S;Yano M;Otaki N;Ikeda H;Fukuo K.
肥胖改变了钠和钾摄入量与血压之间的关系。然而，肥胖对2型糖尿病（T2 DM）患者钠钾平衡和心血管风险之间关系的影响仍不清楚。我们研究了日本T2 D患者（伴或不伴肥胖）的24小时尿钠钾比与血清不对称二甲基精氨酸（ADMA）水平（心血管危险因素）之间的关系。这项横断面研究包括243例住院接受糖尿病教育的T2 DM患者。根据24小时尿液采集计算尿钠/钾比值。根据BMI分为两组（<25和≥25）。非肥胖患者血清ADMA水平与尿钠钾比值呈正相关，而肥胖患者血清ADMA水平与尿钠钾比值无相关性。多元线性回归分析显示，在非肥胖患者中，校正其他混杂因素后，血清ADMA水平与尿钠/钾比值呈正相关。这种相关性在非肥胖的高血压患者中观察到，但在没有高血压的患者中没有观察到。脉搏波速度和内膜中层厚度的测量结果显示，血清ADMA水平的升高与T2 DM受试者动脉粥样硬化进展程度的增加显著相关。此外，膳食摄入评估显示，乳制品以及绿色和黄色蔬菜的摄入量与T2 DM患者的尿钠钾比呈负相关。总之，在日本非肥胖T2 DM患者中，血清ADMA升高可能与尿钠钾比呈正相关。
Obesity modifies the association between sodium and potassium intake and blood pressure. However, the impact of obesity on the relationship between the sodium–potassium balance and cardiovascular risk in type 2 diabetes (T2DM) patients remains unclear. We investigated the relationship between the 24-h urinary sodium-to-potassium ratio and serum asymmetric dimethylarginine (ADMA) level, which is a cardiovascular risk factor, in Japanese T2D patients with or without obesity. This cross-sectional study included 243 patients with T2DM who were hospitalized for diabetes education. Urinary sodium-to-potassium ratios were calculated from 24-h urine collection. The subjects were divided into two groups according to their BMIs (<25 and ≥25). The serum ADMA levels positively correlated with the urinary sodium-to-potassium ratios in non-obese patients, but not in obese patients. Multivariate linear regression analyses showed that the serum ADMA levels positively correlated with the urinary sodium-to-potassium ratios after adjustment for other confounders in non-obese patients. This correlation was observed in non-obese patients with hypertension, but not in those without hypertension. Measurement of the pulse wave velocity and intima–media thickness revealed that elevation of the serum ADMA levels was significantly associated with an increase in the degree of atherosclerotic progression in subjects with T2DM. Additionally, an assessment of dietary intake showed that the consumption of dairy products as well as of green and yellow vegetables was negatively associated with urinary sodium-to-potassium ratios in patients with T2DM. In conclusion, elevation of serum ADMA may be positively associated with the urinary sodium-to-potassium ratio in Japanese non-obese patients with T2DM.