A Study On Relationship Between Plasma Urotensin Ⅱ Levels And Macroangiopathy In Type 2 Diabetes

Background and Objective: Urotensin-II(U-II), a cyclic undecapeptide (H-Glu-Thr-Pro-Asp-c{Cys-Phe-Trp-Lys-Tyr -Cys}-Val-OH) with an intramolecular ring structure connected by two cysteine esidues,originally isolated from the caudal neurosecretory system of the fish has been identified as a vasoactive peptide in mammals.We observed U-II expression in the cardiovascular tissue and nerve tissue widely.Currently,UrotensinⅡis the strongest vasoconstrictor peptide in vivo,and may correlate with atherosclerosis closely.Macroangiopathy is the common complication and major cause of death of type 2 diabetes.Atherosclerosis is the pathological basis of Macroangiopathy.Carotid artery intimal - media thickness (IMT) thickening is the early characteristics of atherosclerosis.Carotis intimal - media thickness thickening is the characteristic appearance of the pathological changes of large artery,and Carotid Doppler ultrasound examination has become the most specific marker for diagnosis in type 2 diabetes with macrovascular.This study was observed the plasma UrotensinⅡlevels and IMT of the patients with type 2 diabetes,to research the relationship between plasma urotensinⅡlevels and macroangiopathy in patients with type 2 diabetes.Make plasma UrotensinⅡlevels become an effective index for early detection,illness assessment and intervention of macroangiopathy in patients with type 2 diabetes.Methods: According to the 1999 diabetes diagnostic criteria by WHO,continuous selected 103 patients without hepatic and kidney disease, acute and chronic infectious diseases, hypertension, coronary heart disease and other cardiovascular and cerebrovascular diseases form the department of endocrine secretion,including 47 men and 56 women with the age range from 37 to 76 (56.63±12.33)years. Selected 31 healthy persons,of which 15 men and 16 women,the age range from 35 to 68 (54.46±12.75 )years,at the same time,excluded diabetes, hypertension, coronary heart disease and other cardiovascular and cerebrovascular diseases and peripheral vascular disease.The blood pressure,body mass index,abdomen circumference and so on of all subjects were collected.To take measure fasting blood glucose,blood fat,hepatic and renal function with venous blood.At the same time,taken 2ml fasting venous blood in the early morning by test tube with EDTA,and added aprotinin in the test tube, fully blended after centrifuged,to take the supernatant cryopreservation at - 70℃in order to detect the plasma UⅡlevels by enzyme-linked immunosorbent assay method.All selected cases were measured the carotid IMT by doppler ultrasound.According to the results,the diabetes patients were divided into three groups:①caseⅠ(DM-Ⅰ):normal for the IMT,(n=39);②caseⅡ(DM-Ⅱ):IMT over 0.9mm,(n=27);③caseⅢ(DM-Ⅲ):the formation of atherosclerotic plaques in carotid,IMT over 1.2mm (n=37).Control group had no abnormalities by carotid ultrasound.Used SPSS13.0 for statistical analysis.To describe measurement data by x±S,compared mean of two groups by t-test,mean of more groups by analysis of variance,rate of two groups byχ2 test, P < 0.05 is significant statistical difference. Conclusion: (1) Compared the mean of age,sex,body mess index,blood pressure and so on among the four groups,the result showed that it was no significant statistical difference (P> 0.05). Compared alike TC,TG,HDL-C,LDL-C,Cr and so on,the result showed that it was no significant statistical difference (P>0.05).(2)The plasma urotensinⅡlevels in the all patients with type 2 diabetes (0.57±0.24 ng / ml ) was significantly higher than control group (0.32±0.11 ng / ml) ( P = 0.010).(3) The plasma urotensinⅡlevels in DM-Ⅰ,DM-Ⅱand DM-Ⅲgroup were 0.49±0.18 ng/ml,0.87±0.31 ng/ml,0.59±0.24 ng/ml respectively, they were higher than the normal control group( P values were 0.000,0.000 and 0.000 respectively). (4)Compared with the plasma urotensinⅡlevels in DM-Ⅰ,DM-Ⅱand DM-Ⅲgroup,the result showed there was significant difference (P= 0.000,0.040and 0.000, respectively), the plasma urotensinⅡlevels from higher to lower is DM-Ⅱ,DM-Ⅲand DM-Ⅰgroup one by one. Conclusion: (1)The plasma urotensinⅡlevels in diabetes is higher than health,suggests that the plasma urotensinⅡlevels may be concerned with certain metabolism of diabetes;(2)In patients with diabetes,the plasma urotensinⅡlevels in the group of carotid IMT thickening is higher than normal IMT group and the formation of atherosclerotic plaques in carotid group,and the plasma urotensinⅡlevels in the group of the formation of atherosclerotic plaques in carotid is higher than normal IMT group,suggests that the plasma urotensinⅡlevels in the macroangiopathy process of diabetes,in particular the formation of atherosclerotic plaques is work;(3)The plasma levels of urotensinⅡmay be suggested that one of effective indicators in the macroangiopathy process of diabetes.