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目的观察糖尿病伴隐蔽性高血压(MHT)患者血清不对称二甲基精氨酸(ADMA)水平的变化。方法纳入诊室正常血压(<140/90mm Hg)的糖尿病患者436例。对所有受试者行24h动态血压监测(ABPM),结合诊室血压,分为正常血压组和MHT组。用高效液相色谱法检测血清ADMA和L-精氨酸的水平。结果在本研究纳入的2型糖尿病患者436例中,104例符合MHT的诊断标准,归为MHT组,余下患者归为正常血压组(n=332),本研究MHT的检出率为23.85%。与正常血压组比较,MHT组ADMA水平升高[(6.82±2.22)比(4.28±1.07)μmol/L,P<0.05]。MHT组L-精氨酸/ADMA较正常血压组降低(24.73±7.83比39.47±14.52,P<0.05)。在多因素Logistic回归模型中,ADMA、体质量指数(BMI)和高密度脂蛋白胆固醇(HDL-C)水平是MHT的影响因素,OR值分别为1.64(1.29~2.07)、1.20(1.06~1.36)和0.93(0.88~0.97;均P<0.05)。结论糖尿病伴MHT患者血清ADMA水平显著升高。ADMA、BMI和HDL-C是糖尿病伴MHT的影响因素。
Objective To investigate the changes of serum asymmetric dimethylarginine (ADMA) level in patients with diabetes complicated with occlusive hypertension (MHT). Methods 436 cases of diabetic patients admitted to the clinic with normal blood pressure (<140/90 mm Hg). All patients underwent 24-hour ambulatory blood pressure monitoring (ABPM), combined with clinic blood pressure, divided into normal blood pressure group and MHT group. Serum levels of ADMA and L-arginine were measured by high performance liquid chromatography. Results Of the 436 patients with type 2 diabetes mellitus included in this study, 104 met MHT criteria and were classified as MHT and the rest were classified as normotensive (n = 332). The detection rate of MHT in this study was 23.85% . The level of ADMA in MHT group was significantly higher than that in normotensive group [(6.82 ± 2.22) vs (4.28 ± 1.07) μmol / L, P <0.05]. L-arginine / ADMA in MHT group was lower than that in normotensive group (24.73 ± 7.83 vs. 39.47 ± 14.52, P <0.05). In the multivariate Logistic regression model, ADMA, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) levels were the influencing factors of MHT with OR values of 1.64 (1.29-2.07), 1.20 ) And 0.93 (0.88 ~ 0.97; all P <0.05). Conclusion Serum ADMA levels in diabetic patients with MHT were significantly increased. ADMA, BMI and HDL-C are the influencing factors of diabetic MHT.