Department of Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore.
Atherosclerosis. 2011 Mar;215(1):176-9. doi: 10.1016/j.atherosclerosis.2010.12.020. Epub 2010 Dec 25.
Patients with type 2 diabetes have increased expression of cell adhesion molecules (CAMs). CAMs and monocyte adhesion mediate essential processes in atherogenesis. It remains unclear if monocytes from patients on niacin have reduced adhesion function.
We studied the variation of monocyte adhesion in patients with type 2 diabetes and low HDL-cholesterol, taking either extended release niacin (Niaspan®, Abbott Laboratories) or controls not on niacin. Biochemical parameters including adiponectin, CAMs and fresh monocytes from whole blood for adhesion assays, were studied at baseline and 12-weeks.
Niacin 1500 mg daily raised HDL-cholesterol from 0.8 mmol/l (95% CI: 0.7-0.9) to 0.9 mmol/l (95% CI: 0.8-1.1), p=0.10, and significantly reduced PECAM-1 by 24.9% (95% CI: 10.9-39.0; p<0.05), increased adiponectin by 30.5% (95% CI: 14.1-47.0; p<0.05), with monocyte adhesion reduced by 9.2% (95%CI: 0.7-17.7; p<0.05) in endothelial cells treated in basal conditions, and 7.8% (95% CI: 3.1-12.5; p<0.05) after TNF-α stimulation.
Monocytes isolated from patients on niacin had reduced adhesion to endothelial cells. Our findings suggest niacin has broad range of effects apart from lipid-modification, and these could be important in cardiovascular risk reduction.
2 型糖尿病患者的细胞黏附分子（CAMs）表达增加。CAMs 和单核细胞黏附介导动脉粥样硬化形成的基本过程。目前尚不清楚烟酸治疗的患者单核细胞黏附功能是否降低。
我们研究了患有 2 型糖尿病和低 HDL-胆固醇的患者单核细胞黏附的变化，这些患者服用的是烟酸（Niaspan®，雅培实验室）或未服用烟酸的对照药物。在基线和 12 周时，研究了包括脂联素、CAMs 和全血新鲜单核细胞在内的生化参数，用于黏附测定。
烟酸 1500mg 每日一次使 HDL-胆固醇从 0.8mmol/L（95%CI：0.7-0.9）增加到 0.9mmol/L（95%CI：0.8-1.1），p=0.10，并显著降低 PECAM-1 24.9%（95%CI：10.9-39.0；p<0.05），增加脂联素 30.5%（95%CI：14.1-47.0；p<0.05），基础条件下内皮细胞处理时单核细胞黏附减少 9.2%（95%CI：0.7-17.7；p<0.05），TNF-α 刺激后减少 7.8%（95%CI：3.1-12.5；p<0.05）。
从服用烟酸的患者中分离出的单核细胞黏附于内皮细胞的能力降低。我们的研究结果表明，烟酸除了具有脂质修饰作用外，还具有广泛的作用，这可能对降低心血管风险很重要。
