Bernard Sophie, Loffroy Romaric, Sérusclat André, Boussel Loïc, Bonnefoy Eric, Thévenon Chantal, Rabilloud Muriel, Revel Didier, Moulin Philippe, Douek Philippe
Endocrinology, Diabetes and Nutrition Department, Cardiovascular Hospital, Hospices Civils de Lyon, France.
Atherosclerosis. 2009 Apr;203(2):429-35. doi: 10.1016/j.atherosclerosis.2008.07.039. Epub 2008 Aug 12.
The combination of both morphological and cellular markers of subclinical atherosclerosis, in addition to conventional risk factors, may help to improve cardiovascular prevention in type 2 diabetic patients. The aim of our cross-sectional study was to evidence a putative increase in endothelial (EMP) or platelet (PMP) microparticles, in type 2 diabetic patients with coronary noncalcified plaques detected by multidetector CT (MDCT).
Microparticles and coronary MDCT were assessed in 56 type 2 diabetic patients with different cardiovascular risk levels. Both EMP (r=0.35, p=0.022) and PMP (rho=0.34, p=0.022) were correlated with hsCRP. EMP were elevated in patients with acute coronary syndromes (p=0.034). EMP count was significantly higher in the presence of noncalcified diseased segments (p=0.01). By contrast, there was no association between hsCRP and noncalcified atheroma. This increase in EMP in noncalcified diseased segment carriers remained borderline significant after adjustment for coronary heart disease and hsCRP. Conversely, there was no association of PMP count with noncalcified diseased segments and no difference in PMP count between patients with and without acute coronary syndrome. No significant association between either EMP and PMP counts and mixed or calcified diseased segments was observed.
We report for the first time an association between plasma EMP-CD144+ and coronary noncalcified plaques assessed by MDCT in a population of type 2 diabetic patients. EMP might be used as a surrogate marker of unstable plaques, and might help to improve cardiovascular prediction in diabetic patients with intermediate risk.
除传统危险因素外,亚临床动脉粥样硬化的形态学和细胞标志物相结合,可能有助于改善2型糖尿病患者的心血管预防。我们横断面研究的目的是证实,在通过多排CT(MDCT)检测出有冠状动脉非钙化斑块的2型糖尿病患者中,内皮微粒(EMP)或血小板微粒(PMP)可能增加。
对56名具有不同心血管风险水平的2型糖尿病患者进行了微粒和冠状动脉MDCT评估。EMP(r=0.35,p=0.022)和PMP(rho=0.34,p=0.022)均与hsCRP相关。急性冠状动脉综合征患者的EMP升高(p=0.034)。在存在非钙化病变节段的患者中,EMP计数显著更高(p=0.01)。相比之下,hsCRP与非钙化动脉粥样硬化之间没有关联。在对冠心病和hsCRP进行校正后,非钙化病变节段携带者中EMP的这种增加仍接近显著水平。相反,PMP计数与非钙化病变节段没有关联,急性冠状动脉综合征患者与非急性冠状动脉综合征患者之间的PMP计数没有差异。未观察到EMP和PMP计数与混合或钙化病变节段之间有显著关联。
我们首次报告了在2型糖尿病患者群体中,血浆EMP-CD144+与通过MDCT评估的冠状动脉非钙化斑块之间存在关联。EMP可能用作不稳定斑块的替代标志物,并可能有助于改善中度风险糖尿病患者的心血管预测。