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2 型糖尿病患者急性心肌梗死后及梗死后恢复期的血浆脂联素水平。

Plasma adiponectin levels in acute myocardial infarction and during the postinfarction recovery period in patients with type 2 diabetes mellitus.

机构信息

Department of Gastroenterology and Metabolic Diseases, Medical University of Warsaw, Warsaw, Poland.

出版信息

Kardiol Pol. 2011;69(9):924-30.

Abstract

BACKGROUND

Adiponectin is a protein produced by the adipose tissue, exhibits potential antiatherogenic properties and is involved in the pathogenesis of insulin resistance. Adiponectin levels are decreased in patients with cardiovascular diseases and type 2 diabetes (DM).

AIM

To assess the changes in adiponectin levels following acute myocardial infarction (MI) and to evaluate the correlation between adiponectin and C-reactive protein (CRP) in patients with DM.

METHODS

Coronary angiography was performed in 56 patients with acute MI--33 patients with DM (23 men, 10 women, mean age 64.0 ± 11.7 years) and 23 non-diabetic subjects (17 men, 6 women, mean age 58.6 ± 9.9 years). All the patients underwent a medical examination and their body mass indexes and waist-to-hip ratios were calculated. Venous blood samples were collected 24 hours, 5 days and 3 weeks following admission.

RESULTS

Plasma adiponectin levels in non-diabetic patients were significantly higher during the postinfarction recovery period than in the acute phase of MI (7.9 ± 3.5 μg/mL vs 7.0 ± 2.7 μg/mL). Plasma adiponectin levels in diabetic patients were significantly lower on Day 21 compared to Day 5 (6.0 ± 2.5 μg/mL vs 6.7 ± 3.1 μg/mL). The changes in plasma adiponectin levels (the difference in plasma adiponectin levels between Days 5 and 21) negatively correlated with CRP levels (r = -0.41, p = 0.001). Adiponectin levels were significantly associated with waist circumference (T2DM: r = -0.34, p = 0.04; control group: r = -0.48, p = 0.001).

CONCLUSIONS

Plasma adiponectin levels in diabetic patients with acute MI were significantly lower during the postinfarction recovery period. These findings suggest a higher and longer adiponectin utilisation in the regeneration process. A strong inflammatory activity in the atheromatous plaque may decrease plasma adiponectin levels.

摘要

背景

脂联素是一种由脂肪组织产生的蛋白质,具有潜在的抗动脉粥样硬化特性,并参与胰岛素抵抗的发病机制。患有心血管疾病和 2 型糖尿病(DM)的患者脂联素水平降低。

目的

评估急性心肌梗死(MI)后脂联素水平的变化,并评估 DM 患者脂联素与 C 反应蛋白(CRP)之间的相关性。

方法

对 56 例急性 MI 患者进行冠状动脉造影检查-33 例 DM 患者(23 名男性,10 名女性,平均年龄 64.0±11.7 岁)和 23 名非糖尿病患者(17 名男性,6 名女性,平均年龄 58.6±9.9 岁)。所有患者均进行了体格检查,并计算了体重指数和腰臀比。入院后 24 小时、第 5 天和第 3 周采集静脉血样。

结果

非糖尿病患者在梗死后恢复期的血浆脂联素水平明显高于急性 MI 期(7.9±3.5μg/mL 比 7.0±2.7μg/mL)。糖尿病患者在第 21 天的血浆脂联素水平明显低于第 5 天(6.0±2.5μg/mL 比 6.7±3.1μg/mL)。血浆脂联素水平的变化(第 5 天和第 21 天之间血浆脂联素水平的差异)与 CRP 水平呈负相关(r=-0.41,p=0.001)。脂联素水平与腰围显著相关(T2DM:r=-0.34,p=0.04;对照组:r=-0.48,p=0.001)。

结论

急性 MI 合并糖尿病患者在梗死后恢复期的血浆脂联素水平明显降低。这些发现表明,在再生过程中,脂联素的利用率更高、持续时间更长。动脉粥样斑块中的强烈炎症活性可能会降低血浆脂联素水平。

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