Gómez José Manuel, Vila Ramon, Catalina Pablo, Soler Juan, Badimón Lina, Sahún Manel
Department of Endocrinology and Nutrition, University Hospital of Bellvitge, Barcelona, Spain.
Glycoconj J. 2008 Aug;25(6):573-9. doi: 10.1007/s10719-008-9118-8. Epub 2008 Mar 18.
The aim of this study is to test several biomarkers of inflammation, of endothelial dysfunction, glycated haemoglobin, and their reflection in arterial dilatation, in patients with type 2 diabetes mellitus and in their relatives, in order to demonstrate if relatives present markers as a form of precocious indicators of diabetes mellitus. Individuals between 30 and 55 years of age and without clinical arterial disease were divided in three groups: type 2 diabetes mellitus patients without complications (12 men and 18 women); first degree relatives of type 2 diabetes mellitus (14 men and 20 women); and control individuals (9 men and 16 women). Body composition was measured with a bioelectrical impedance analyzer and endothelial function with an eco-Doppler device. We determined glucose, insulin, C-peptide, glycated haemoglobin, fibrinogen, E-selectin, P-selectin, soluble intercellular cell adhesion molecule-1 (ICAM-1), soluble vascular cell adhesion molecule-1 (VCAM-1), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), C-reactive protein (CRP) in plasma. We also studied endothelium independent dilatation and endothelium dependent dilatation.
ICAM-1 and VCAM-1 were significantly higher in the diabetic group (237.5+/-43.4 and 692.5+/-168.6 ng/l) than in controls (197.4+/-51.2 and 573.5+/-121.1 ng/l, p=0.011 and 0.013, respectively), but were not higher in the family group (224.5+/-45.2 and 599.8+/-150.4 ng/l). CRP was higher in the diabetic group (3.35+/-3.27 mg/l) than in the other groups (1.28+/-1.29 and 1.61+/-1.54 mg/l, p=0.002) and correlated with glycated haemoglobin. The non-endothelium mediated dilatation was lesser in the diabetic group than in the family group (17.3+/-6.1 vs. 24+/-8, p=0.029) and controls. In conclusion patients with uncomplicated type 2 diabetes, but not their relatives, have biochemical markers of sub-clinical inflammation in relationship with glycated haemoglobin and dysfunction of the endothelial cells markers. In these patients endothelium independent dilatation is more affected than endothelium dependent dilatation.
本研究旨在检测2型糖尿病患者及其亲属体内几种炎症生物标志物、内皮功能障碍生物标志物、糖化血红蛋白及其在动脉扩张中的反映情况,以证明亲属是否存在作为糖尿病早熟指标形式的标志物。年龄在30至55岁且无临床动脉疾病的个体被分为三组:无并发症的2型糖尿病患者(12名男性和18名女性);2型糖尿病患者的一级亲属(14名男性和20名女性);以及对照个体(9名男性和16名女性)。使用生物电阻抗分析仪测量身体成分,使用生态多普勒设备测量内皮功能。我们测定了血浆中的葡萄糖、胰岛素、C肽、糖化血红蛋白、纤维蛋白原、E选择素、P选择素、可溶性细胞间黏附分子-1(ICAM-1)、可溶性血管细胞黏附分子-1(VCAM-1)、白细胞介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)、C反应蛋白(CRP)。我们还研究了内皮依赖性扩张和非内皮依赖性扩张。
糖尿病组的ICAM-1和VCAM-1水平(分别为237.5±43.4和692.5±168.6 ng/l)显著高于对照组(分别为197.4±51.2和573.5±121.1 ng/l,p = 0.011和0.013),但在家族组中并不更高(分别为224.5±45.2和599.8±150.4 ng/l)。糖尿病组的CRP水平(3.35±3.27 mg/l)高于其他组(分别为1.28±1.29和1.61±1.54 mg/l,p = 0.002),且与糖化血红蛋白相关。糖尿病组的非内皮介导扩张低于家族组(分别为17.3±6.1与24±8,p = 0.029)和对照组。总之,无并发症的2型糖尿病患者而非其亲属具有与糖化血红蛋白和内皮细胞功能障碍标志物相关的亚临床炎症生化标志物。在这些患者中,非内皮依赖性扩张比内皮依赖性扩张受影响更大。