Asymmetrical dimethylarginine is related to renal function, chronic inflammation and macroangiopathy in patients with Type 2 diabetes and albuminuria
Asymmetrical dimethylarginine is related to renal function, chronic inflammation and macroangiopathy in patients with Type 2 diabetes and albuminuria
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DOI：
10.1111/j.1464-5491.2007.02018.x
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发表时间：
2007-01-01
影响因子：
3.5
通讯作者：
Schernthaner, G.
中科院分区：
文献类型：
--
作者：
Krzyzanowska, K.;Mittermayer, F.;Schernthaner, G.
目标 患有 2 型糖尿病 (T2DM) 和微量白蛋白尿和大量白蛋白尿的患者心血管风险增加。内源性一氧化氮合酶抑制剂不对称二甲基精氨酸（ADMA）在肾功能衰竭时会增加，并可能促进动脉粥样硬化。为了确定 ADMA、肾白蛋白排泄率 (AER) 和心血管风险之间的关系，我们对 103 名 T2DM 患者进行了研究。方法通过高效液相色谱法测定 36 名正常、40 微量白蛋白尿和 27 名巨量白蛋白尿 T2DM 患者（年龄 64 +/- 11 岁；38 名女性）的血浆中的 ADMA、对称二甲基精氨酸 (SDMA) 和 L-精氨酸，这些患者的年龄、性别和年龄具有可比性。代谢参数。 46 例患者患有大血管疾病 (MVD)。 结果 与正常白蛋白尿患者 [0.55 (0.48-0.63) muol/l] 相比，微量白蛋白尿患者和大量白蛋白尿患者 [中位数分别为 0.61（四分位距 0.55-0.70）μmol/l 和 0.62（0.50-0.79）μmol/l] 患者的 ADMA 显着升高。摩尔/升；两者 P < 0.05]。与正常白蛋白尿受试者 [0.44 (0.37-0.53) mu mol/l] 相比，微量白蛋白尿和大量白蛋白尿 [0.57 (0.42-0.80) mu mol/l 和 0.64 (0.50-0.96) mu mol/l] 的 SDMA 升高；两者 P < 0.01]。与无 MVD 的患者相比，AER 和 MVD 增加的患者 ADMA 和 SDMA 较高（均 P < 0.001）。 L-精氨酸在所有组之间具有可比性。 ADMA 与高敏 C 反应蛋白 (hsCRP) 和肾小球滤过率 (GFR) 显着相关，但与白蛋白排泄程度、体重指数、空腹血糖、HbA(1c) 或血脂无关。 结论 伴有蛋白尿的 T2DM 患者中 ADMA 升高与心血管疾病相关，并与肾功能不全和亚临床炎症相关。
Aims Patients with Type 2 diabetes mellitus (T2DM) and micro- and macroalbuminuria are at increased cardiovascular risk. The endogenous nitric oxide synthase inhibitor asymmetrical dimethylarginine (ADMA) is increased in renal failure and could promote atherosclerosis. To determine the relationship between ADMA, renal albumin excretion rate (AER) and cardiovascular risk, we studied 103 T2DM patients.MethodsADMA, symmetrical dimethylarginine (SDMA) and L-arginine were determined by high-performance liquid chromatography in plasma from 36 normo-, 40 micro- and 27 macroalbuminuric patients with T2DM (age 64 +/- 11 years; 38 women) who had comparable age, sex and metabolic parameters. Forty-six patients had macrovascular disease (MVD).Results ADMA was significantly increased in patients with micro- and macroalbuminuria [median 0.61 (interquartile range 0.55-0.70) mu mol/l and 0.62 (0.50-0.79) mu mol/l, respectively] compared with those with normoalbuminuria [0.55 (0.48-0.63) mu mol/l; both P < 0.05]. SDMA was elevated in micro- and macroalbuminuria [0.57 (0.42-0.80) mu mol/l and 0.64 (0.50-0.96) mu mol/l] compared with normoalbuminuric subjects [0.44 (0.37-0.53) mu mol/l; both P < 0.01]. Patients with increased AER and MVD had higher ADMA and SDMA compared with those without MVD (both P < 0.001). L-arginine was comparable between all groups. ADMA correlated significantly with high-sensitivity C-reactive protein (hsCRP) and glomerular filtration rate (GFR) but not with the extent of albumin excretion, body mass index, fasting glucose, HbA(1c) or plasma lipids.Conclusions Increased ADMA in T2DM patients with albuminuria is linked to cardiovascular disease and is associated with renal dysfunction and subclinical inflammation.