Rigla Mercedes, Wägner Ana Maria, Borrell Montserrat, Mateo José, Foncuberta Jordi, de Leiva Alberto, Ordóñez-Llanos Jordi, Pérez A
Endocrinology Department, Hospital Sant Pau. S Antoni M Claret 167, 08025 Barcelona, Spain.
Metabolism. 2006 Nov;55(11):1437-42. doi: 10.1016/j.metabol.2005.11.010.
The aim of this study was to assess postprandial changes in thrombin activatable fibrinolysis inhibitor (TAFI) antigen, a thrombin-dependent fibrinolysis inhibitor with anti-inflammatory properties, and soluble markers of endothelial dysfunction in normotriglyceridemic type 2 diabetic patients. Fasting and postprandial TAFI antigen, thrombomodulin, tissue factor pathway inhibitor (TFPI), and plasminogen activator inhibitor 1 were assessed in 12 normotriglyceridemic type 2 diabetic patients treated with diet (hemoglobin A1c, 6.80% +/- 0.67%) and 14 controls. Fasting low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, free fatty acids and apolipoprotein B, and fasting and postprandial triglyceride, glucose, and insulin were also measured. Fasting TAFI was higher in the control group (102% +/- 16.9% vs 72.9% +/- 15.9%; P < .0005) and was inversely correlated with glycemic control. It decreased 4 hours after the meal (31.8% reduction [P < .005] for controls and 12.6% [P < .05] for diabetic patients) and returned to fasting levels after 8 hours. This decrement was correlated with fasting TAFI, glucose and hemoglobin A1c, and the area under the curve of glucose. Thrombomodulin, TFPI, and plasminogen activator inhibitor 1 were similar in both groups, with thrombomodulin and TFPI showing a transient postprandial increase. A fat-rich meal produces a transient increase in markers of endothelial dysfunction and a temporary reduction in TAFI, an anti-inflammatory molecule whose concentration is low in type 2 diabetes mellitus.
本研究旨在评估正常甘油三酯血症的2型糖尿病患者餐后凝血酶激活的纤溶抑制物（TAFI）抗原（一种具有抗炎特性的凝血酶依赖性纤溶抑制物）及内皮功能障碍的可溶性标志物的变化。对12例接受饮食治疗的正常甘油三酯血症的2型糖尿病患者（糖化血红蛋白，6.80%±0.67%）和14名对照者进行了空腹及餐后TAFI抗原、血栓调节蛋白、组织因子途径抑制物（TFPI）和纤溶酶原激活物抑制物1的评估。还测量了空腹低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、游离脂肪酸和载脂蛋白B，以及空腹和餐后甘油三酯、葡萄糖和胰岛素。对照组的空腹TAFI较高（102%±16.9%对72.9%±15.9%；P<.0005），且与血糖控制呈负相关。餐后4小时其下降（对照组下降31.8%[P<.005]，糖尿病患者下降12.6%[P<.05]），8小时后恢复到空腹水平。这种下降与空腹TAFI、葡萄糖和糖化血红蛋白以及葡萄糖曲线下面积相关。两组的血栓调节蛋白、TFPI和纤溶酶原激活物抑制物1相似，血栓调节蛋白和TFPI餐后有短暂升高。富含脂肪的餐食会使内皮功能障碍标志物短暂升高，使TAFI暂时降低，TAFI是一种抗炎分子，其在2型糖尿病中的浓度较低。
