Correlation between asymmetric dimethylarginine and endothelial dysfunction in patients with type 2 diabetic nephropathy / 中国医师进修杂志

ABSTRACT

Objective To investigate the correlation between asymmetric dimethylarginine (ADMA) and endothelial dysfunction in patients with type 2 diabetic nephropathy.Methods The 81 patients with type 2 diabetic nephropathy were selected.According to the urinary albumin excretion rate (UAER),the patients were divided into micro-albuminuria group (DN1 group,UAER 21-199 mg/24 h,38 cases) and macro-albuminuria group (DN2 group,UAER ≥ 200 mg/24 h,43 cases).The 20 healthy people were defined as control group.Intimal-media thickness and endothelial dysfunction of the radial artery of right forearm were detected by color Doppler ultrasound.The serum level of ADMA was determined by enzyme-linked immunosorbent assay.Results There was no significant difference in radial artery inner diameter intimal-media thickness among the 3 groups (P ＞ 0.05).The Endothelial dependent diastolic function (EDD) and endothelial independent diastolic function (EID) in DN1 group and DN2 group were significantly lower than those in control group [(10.45 ± 2.58)％ and (7.56 ± 2.17)％ vs.(15.72 ± 3.05)％,(15.42 ± 2.71)％ and (15.37 ± 2.92)％ vs.(19.31 ± 3.76)％,P ＜ 0.05],and the EDD in DN2 group was significantly lower than that in DN1 group (P＜ 0.05).The serum ADMA in DN1 group and DN2 group was significantly higher than that in control group [(0.63 ± 0.08) and (0.92 ± 0.12) μ mol/L vs.(0.39 ± 0.05)μmol/L,P ＜0.05],and in DN2 group it was significantly higher than that in DN1 group (P ＜0.05).In patients with type 2 diabetic nephropathy,the serum ADMA and EDD had negative correlation (r =-0.81,P =0.020),but the serum ADMA and C reactive protein had positive correlation (r =0.75,P =0.034).Conclusions The serum level of ADMA is significantly increased in patients with type 2 diabetic nephropathy.There is a close correlation between ADMA and endothelial dysfunction of artery.