Department of Cardiology, Oita Red Cross Hospital, Oita, Japan.
Eur J Clin Invest. 2010 Jul;40(7):585-90. doi: 10.1111/j.1365-2362.2010.02301.x. Epub 2010 May 23.
The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. Elevated hepatocyte growth factor (HGF) levels are associated with a high mortality rate in type 2 diabetic patients. The preliminary study was therefore designed to test the hypothesis that the presence of WML correlates with HGF and insulin resistance in type 2 diabetic patients not receiving insulin treatment.
Based on brain magnetic resonance imaging, 92 type 2 diabetic patients were divided into two groups: WML-positive group (age 60 +/- 5 years, mean +/- SD, n = 35) and WML-negative group (age 59 +/- 6 years, mean +/- SD, n = 57. The level of blood glucose was assessed by fasting plasma glucose, fasting immunoreactive insulin, homeostasis model assessment (HOMA) index and haemoglobin A1c (HbA1c).
The body mass index was higher in the WML-positive group than that in the WML-negative group (P < 0.005). Plasma levels of triglycerides were higher while high-density lipoprotein cholesterol was lower in the WML-positive group than in the WML-negative group (P < 0.01 and P < 0.0001 respectively). Fasting plasma glucose (P < 0.0001), insulin concentrations (P < 0.0001), HOMA index (P < 0.0001) and HGF (< 0.0001) levels were higher in the WML-positive group than in the WML-negative group. Multivariate logistic analysis revealed that WML was independently predicted by the high HGF and insulin resistance (P < 0.0001 and P < 0.0001 respectively).
The results of this preliminary study indicate that the presence of WML was associated with the high HGF and insulin resistance in Japanese patients with type 2 diabetes mellitus.
脑白质病变(WML)的存在是中风发展的一个重要预后因素。肝细胞生长因子(HGF)水平升高与 2 型糖尿病患者的高死亡率相关。因此,初步研究旨在检验以下假设,即 WML 的存在与未接受胰岛素治疗的 2 型糖尿病患者的 HGF 和胰岛素抵抗相关。
根据脑磁共振成像,将 92 名 2 型糖尿病患者分为两组:WML 阳性组(年龄 60 +/- 5 岁,平均值 +/- SD,n = 35)和 WML 阴性组(年龄 59 +/- 6 岁,平均值 +/- SD,n = 57)。通过空腹血糖、空腹免疫反应性胰岛素、稳态模型评估(HOMA)指数和糖化血红蛋白(HbA1c)评估血糖水平。
WML 阳性组的体重指数高于 WML 阴性组(P < 0.005)。WML 阳性组的血浆甘油三酯水平较高,高密度脂蛋白胆固醇水平较低(P < 0.01 和 P < 0.0001)。WML 阳性组的空腹血糖(P < 0.0001)、胰岛素浓度(P < 0.0001)、HOMA 指数(P < 0.0001)和 HGF(P < 0.0001)水平均高于 WML 阴性组。多变量 logistic 分析显示,WML 独立于高 HGF 和胰岛素抵抗预测(P < 0.0001 和 P < 0.0001)。
本初步研究结果表明,在日本 2 型糖尿病患者中,WML 的存在与高 HGF 和胰岛素抵抗相关。