Increased Serum Glycated Albumin Level is Associated With the Presence and Severity of Coronary Artery Disease in Type 2 Diabetic Patients
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概要
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Background Glycated albumin is the predominant circulating Amadori-type glycated protein in vivo and plays a major role in the development of diabetic vascular complications. The aim of this study was to assess the relationship between increased serum glycated albumin level and the presence and severity of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). Methods and Results In a total of 320 consecutive patients with T2DM, coronary angiography revealed normal coronary arteries in 83 patients (control group) and significant coronary stenosis (⪈70% luminal diameter narrowing) in 237, of whom 51 patients had 1-vessel disease (Group I), 80 had 2-vessel disease (Group II), and 106 had 3-vessel disease (Group III). Serum glycated albumin, hemoglobin A_<lc> (HbA_<lc>) and tumor necrosis factor (TNF)-α levels, lipid profile, and renal function were measured. Logistic regression analysis was performed to determine the relative risk of serum glycated albumin level for the presence and severity of CAD. Multivariate stepwise linear regression analysis was done to identify independent determinants of the glycated albumin level. Serum glycated albumin (21.2+53% vs 19.4±4.3%, p=0.005) and TNF-α levels (123±115pg/ml vs 65±59pg/ml, p<0.001) were significantly higher in patients with CAD than in controls, but serum HbAlc level did not significantly differ between them (7.6±1.3% vs 7.4±1.2%, p=0.19). There was a significant difference in serum glycated albumin level between Groups I and II (19.5±3.3% vs 21.8±5.7%, p<0.001). The serum glycated albumin level correlated with the number of diseased arteries (Spearman r=0.205, p<0.001), and was closely related to serum levels on admission of glucose (r=0.495, p<0.001), TNF-α (r=0.123, p=0.028), blood urea nitrogen (r=0.167, p=0.004), triglycerides (r=0.129, p=0.021), and HbA_<lc> (r=0.795, p<0.001). Multivariate analysis indicated that serum levels of glucose (p<0.0001), TNF-α (p=0.001), blood urea nitrogen (p=0.004) and triglycerides (p=0.035) were independent determinants for glycated albumin. Logistic regression analysis revealed that glycated albumin ⪈19% (odds ratio (OR) 2.9, p<0.001) was an independent predictor for CAD and glycated albumin ⪈21% (OR 2.3, p=0.032) for 3-vessel disease prediction. The area under the receiver-operating characteristic curve for glycated albumin (0.620, 95% confidence interval (CI) 0.548 to 0.691, p=0.001) was superior to that for HbAlc (0.543, 95% CI 0.473 to 0.613, p=0.243). Conclusions An increased serum level of glycated albumin is associated with the presence and severity of CAD, and may be useful in screening patients with T2DM.
- 社団法人日本循環器学会の論文
- 2007-06-20
著者
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Yang Zheng
Department Of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School Of Medicine
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ZHANG Qi
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine
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ZHANG Rui
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine
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HU Jian
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine
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ZHANG Jian
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine
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DING Feng
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine
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SHEN Wei
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine
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Hu Jian
Department Of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School Of Medicine
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Chen Qiu
Institute Of Cardiovascular Diseases Jiao Tong University School Of Medicine
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Shen Wei
Department Of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School Of Medicine
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Ding Feng
Department Of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School Of Medicine
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SHEN Jie
Department of Pharmacy, Huashan Hospital, Fudan University
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Pu Li
Department of Cardiology, Rui Jin Hospital
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Lu Lin
Department of Cardiology, Rui Jin Hospital
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Fang Dan
Institute of Cardiovascular Diseases, Jiaotong University School of Medicine
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Lou Sheng
Institute of Cardiovascular Diseases, Jiaotong University School of Medicine
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Zhang Jian
Department Of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School Of Medicine
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Pu Li
Institute Of Cardiovascular Diseases Jiao Tong University School Of Medicine
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Lu Lin
Department Of Cardiology Rui Jin Hospital Jiao Tong University School Of Medicine
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Shen Jie
Department Of Cardiology Rui Jin Hospital
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Fang Dan
Department Of Cardiology Rui Jin Hospital Jiao Tong University School Of Medicine
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Zhang Qi
Department Of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School Of Medicine
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Lou Sheng
Institute Of Cardiovascular Diseases Jiao Tong University School Of Medicine
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Zhang Rui
Department Of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School Of Medicine
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Zhang Rui
Department Of Biology The Pennsylvania State University
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Zhang Rui
Department Of Biochemistry And Molecular Biology Fourth Military Medical University
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Zhang Jian
Department Of Biology Huaihua College
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Zhang Jian
Department of Biochemistry and Molecular Biology, The State Key Laboratory of Cancer Biology, The Fourth Military Medical University
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