Association Of HbA1c Level With Vascular Endothelia Function And Diabetic Nephropathy

Objective To compare Plasma endothelin-1(ET-1),Angiotensin-Ⅱ(Ang-Ⅱ)and Urine-microalbuminuria(UMA) in different glycosylated hemoglobin (HbA1c) level in diabetes patients and normal subject. Analyze the relationship betweeHbA1c level and ET -1, Ang-Ⅱand UMA; discuss the effect of the HbAlc level on vascular endothelia function and diabetic nephropathy (DN).Methods We selected 60 patient of diabetes into treatment group in September 2009 to September 2010, and selected 30 normal subjects into control group. Test the levels of Glycosylated hemoglobinA1c(HbA1c),Plasma endothelin-1(ET-1),Angiotensin-Ⅱ(Ang-Ⅱ)and urine-microalbuminuria (UMA) .Additionally, fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPBG), The 60 cases were divided into 2 groups according to the result of HbA1c, group A 30 patients: 6.5%< HbA1c<8%; group B 30 patients:HbA1c≥8%. HbA1c was measured by ion exchange chromatography, ET-1and Ang-Ⅱby radioimmunoassay, and UMA by enzyme-linked immunosorbent assay. FBG and 2hPBG was measured in the finger blood. All the results of three groups were analyzed by statistics. Comparing the level of ET -1, Ang-Ⅱand UMA in groups,analyzing the correlationship with HbA1c.Results 1.(1)Three groups compared in general conditions:three groups were no significant different in age, sex, blood pressure and course of DM(P>0.05) .(2)The comparison of ET -1 level in three groups: There were significant different in ET -1(P<0.05). (3) The comparison of Ang-Ⅱlevel in three groups: There were significant different in Ang-Ⅱ(P<0.05). (3) The comparison of UMA level in three groups: There were significant different in UMA (P<0.05). 2.Correlation analysis: ET -1,Ang-Ⅱand UMA levers were positively correlated with HbA1c lever.Conclusions(1) The ET-1,Ang-Ⅱwere increased with the increasing of HbA1c.and the increasing of HbA1c perhaps had relation with vascular endothelial function change .(2) The UMA was increased with the increasing of HbA1c, the increasing of HbA1c perhaps had relation with the development process of DN.(3) The combined detection of HbA1c and UMA had great significance for the diagnosis and therapy of early diabetic nephropathy.(4) The plasma ET-1,Ang-Ⅱmay detectable for the process of DN.