Cosson E, Bringuier A F, Paries J, Guillot R, Vaysse J, Attali J R, Feldmann G, Valensi P
Department of Diabetology-Endocrinology-Nutrition, AP-HP, Paris-Nord University, Jean Verdier Hospital, and Laboratory of Nutrition and Metabolic Diseases, Paris-Nord University, Bondy, France.
Diabetes Metab. 2005 Feb;31(1):47-54. doi: 10.1016/s1262-3636(07)70166-0.
In type 2 diabetic patients with no cardiac history or symptoms, 1) to evaluate whether the soluble forms of Fas (sFas) and Fas-ligand (sFasL), involved in apoptosis, may be markers of silent coronary disease or related to hypertension or microangiopathic complications; 2) to examine the effect of short-term glycemic control on sFas and sFasL.
(1) sFas and sFasL were measured with the ELISA method in 44 asymptomatic diabetic patients, 33 with hypertension, and with a normal myocardial scintigraphy (n=14), with silent myocardial ischemia (SMI) and without (n=15) or with (n=15) significant coronary stenoses; and in 14 controls; (2) sFas and sFasL were measured in 15 poorly controlled diabetic patients before and after 7 days of CSII treatment.
(1) sFas and sFasL differed in the four groups of patients (p=0.003 each). sFas was significantly higher in the patients with SMI without (p=0.035) and with coronary stenoses (p=0.002) than in the control group. sFasL was lower in the three groups of diabetic patients (p<0.05 each) than in control group. In the diabetic population, sFas correlated positively with hypertension (p=0.021), and sFasL negatively with hypertension (p=0.027) and HOMA index in the non-insulin treated patients (p=0.049); (2) sFas did not differ before or after CSII, and there was a marginal decrease in sFasL.
Fas-mediated apoptosis is involved in type 2 diabetes and might be associated with hypertension and/or its vascular consequences. sFasL might be affected by insulin resistance. sFas and sFasL are not effective markers of SMI.
在无心脏病史或症状的2型糖尿病患者中，1）评估参与细胞凋亡的可溶性Fas（sFas）和Fas配体（sFasL）是否可能是无症状冠心病的标志物，或与高血压或微血管并发症相关；2）研究短期血糖控制对sFas和sFasL的影响。
（1）采用酶联免疫吸附测定法（ELISA）检测44例无症状糖尿病患者、33例高血压患者以及心肌闪烁显像正常（n = 14）、有无症状心肌缺血（SMI）且无（n = 15）或有（n = 15）显著冠状动脉狭窄患者的sFas和sFasL水平；并检测14例对照者的上述指标；（2）检测15例血糖控制不佳的糖尿病患者在持续皮下胰岛素输注（CSII）治疗7天前后的sFas和sFasL水平。
（1）四组患者的sFas和sFasL水平存在差异（每组p = 0.003）。无冠状动脉狭窄（p = 0.035）和有冠状动脉狭窄（p = 0.002）的SMI患者的sFas水平显著高于对照组。三组糖尿病患者的sFasL水平均低于对照组（每组p < 0.05）。在糖尿病患者群体中，sFas与高血压呈正相关（p = 0.021），sFasL与高血压呈负相关（p = 0.027），且在未接受胰岛素治疗的患者中与稳态模型评估胰岛素抵抗指数（HOMA指数）呈负相关（p = 0.049）；（2）CSII治疗前后sFas水平无差异，sFasL水平略有下降。
Fas介导的细胞凋亡与2型糖尿病有关，可能与高血压和/或其血管后果相关。sFasL可能受胰岛素抵抗影响。sFas和sFasL不是SMI的有效标志物。
