Xiang Guang-da, Sun Hui-ling, Zhao Lin-shuang
Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan 430070, Hubei Province, PR China.
Diabetes Res Clin Pract. 2007 May;76(2):199-206. doi: 10.1016/j.diabres.2006.09.008. Epub 2006 Oct 4.
Osteoprotegerin (OPG) regulates osteoclast and immune functions and appears to represent a protective factor for vascular system. However, the role of OPG in endothelial dysfunction of type 1 diabetic patients has not been evaluated. The purpose of this study was to investigate the relationship between plasma OPG levels and endothelium-dependent arterial dilation in type 1 diabetic patients.
This study subjects included 22 newly diagnosed type 1 diabetic patients and 28 healthy subjects. All patients were then given insulin therapy for 6 months. Plasma OPG concentration was measured in duplicate by a sandwich ELISA method, and high-resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia and after sublingual glyceryltrinitrate (GTN).
Plasma OPG level in patients before treatment was 3.09+/-0.70 ng/L, which was significantly higher than that in control (2.07+/-0.75 ng/L) (p<0.001). After 6 months treatment, OPG levels decreased markedly (2.58+/-0.59 ng/L) (p<0.001). The flow-mediated endothelium-dependent arterial dilation in patients before treatment was 3.35+/-0.67%, which was significantly lower than that in control (5.17+/-0.83%) (p<0.001), and improved markedly after 6 months treatment (4.27+/-0.63%) (p<0.001). In multivariate analysis, OPG was significantly associated with endothelium-dependent arterial dilation, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and ultra sensitive C-reactive protein (CRP) at baseline (p<0.01). The absolute changes in OPG showed significant correlation with the changes in endothelium-dependent arterial dilation, FBG, HbA1c, and CRP in diabetic patients during the course of treatment (p<0.01).
This study shows that plasma OPG levels are elevated in newly diagnosed type 1 diabetic patients, and that plasma OPG levels are significantly associated with endothelial function.
骨保护素（OPG）调节破骨细胞和免疫功能，似乎是血管系统的一种保护因子。然而，OPG在1型糖尿病患者内皮功能障碍中的作用尚未得到评估。本研究的目的是探讨1型糖尿病患者血浆OPG水平与内皮依赖性动脉扩张之间的关系。
本研究对象包括22例新诊断的1型糖尿病患者和28例健康受试者。然后所有患者接受6个月的胰岛素治疗。采用夹心ELISA法重复测量血浆OPG浓度，并用高分辨率超声测量静息时、反应性充血后及舌下含服硝酸甘油（GTN）后的肱动脉直径。
治疗前患者血浆OPG水平为3.09±0.70 ng/L，显著高于对照组（2.07±0.75 ng/L）（p<0.001）。治疗6个月后，OPG水平显著下降（2.58±0.59 ng/L）（p<0.001）。治疗前患者的血流介导的内皮依赖性动脉扩张为3.35±0.67%，显著低于对照组（5.17±0.83%）（p<0.001），治疗6个月后明显改善（4.27±0.63%）（p<0.001）。多因素分析显示，基线时OPG与内皮依赖性动脉扩张、空腹血糖（FBG）、糖化血红蛋白（HbA1c）和超敏C反应蛋白（CRP）显著相关（p<0.01）。糖尿病患者治疗过程中OPG的绝对变化与内皮依赖性动脉扩张、FBG、HbA1c和CRP的变化显著相关（p<0.01）。
本研究表明，新诊断的1型糖尿病患者血浆OPG水平升高，且血浆OPG水平与内皮功能显著相关。
