·糖尿病足病·

　　王丽娟 余江毅 罗玫

　　基金项目：“十一五”国家科技支撑计划“重大疑难疾病中医药防治研究”-糖尿病及其主要并发症中医药防治方案的研究(2006BAI04A03)

　　作者单位:210029南京，江苏省中医院内分泌科

　　通讯作者:余江毅，E-mail：suxin218@sohu.com

　　【摘要】目的检测DM早期及糖尿病足(DF)0级血浆羧甲基赖氨酸(CML)水平，并探讨CML与糖代谢、病程、年龄的相关性。方法45例DM早期患者(参照1999年WHO糖尿病诊断标准，且尿白蛋白排泄量<200 μg/min或300 mg/d;视网膜病变≤Ⅰ期)，35例DF 为0级的患者(参照Wagner诊断分级标准)，检测空腹状态下血浆CML、FPG、HbA1c及PPG。结果DF组较DM早期组年龄较大、病程较长，血浆CML水平明显升高(P<0.05)。DF 0级患者血浆CML水平在血糖控制不佳患者(HbA1c>7.0%)中显著升高，且均与HbA1c呈显著正相关(r=0.44，P<0.01);同时，CML与2hPG也呈显著正相关(r=0.41，P<0.05)，CML与FPG、病程、年龄均无相关性(P>0.05)。结论DF 0级患者CML水平显著升高，血浆CML与HbA1c、2hPG呈正相关，血浆CML也许是糖氧化的生物标记，且与糖尿病相关并发症有关。

　　【关键词】早期糖尿病;糖尿病足0级;羧甲基赖氨酸

　　doi:10.3969/j.issn.1006-6187.2012.03.007

　　The detection of CML level in plasma in early stage of DM and diabetic foot of Grade 0 and discussing the influence factorsWANG Li-juan, YU Jiang-yi, LUO Mei. Department of Endocrinology, Jiangsu Province Hospital of Traditional Chinese Medicine. Nanjing 210029,China

　　Corresponding author：YU Jiang-yi, E-mail: suxin218@sohu.com

　　【Abstract】ObjectiveTo detect the level of carboxymethyllysine (CML) in early stage of diabetes mellitu (DM) and grade 0 diabetic foot (DF) and discuss the relevance of CML with glucose metabolism, disease course and age. Methods45 patients with early stage of DM were diagnosed by 1999 WHO diagnostic criteria for diabetes， with urinary albumin excretion<200 μg/min or 300 mg/d，retinopathy≤period I and 35 patients with DF Grade 0. CML, HbA1c, FPG and 2hPG were tested.ResultsThere were older age, longer duration，higher level of CML in DF grade 0 group than in early stage of DM group (all P<0.05). The level of plasma CML in patients with poor glycemic control (HbA1c> 7.0%) in DF Grade 0 group was significantly increased and related to HbA1c and 2hPG positively (r=0.44, P<0.01 and r=0.41, P<0.05). There was no correlation of CML with FPG, disease course and age, separately (P>0.05).ConclusionThe CML level increases significantly in DF Grade 0, which is positively correlated with HbA1c and 2hPG.CML may be a biomarker of glucose oxidation and related with diabetes-related complications.

　　【Key words】Diabetes mellitus, early stage; Diabetic foot, Grade 0; Carboxy methyllysine (CML)