Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka Str., 31-202 Kracow, Poland.
Inflammation. 2012 Jun;35(3):834-40. doi: 10.1007/s10753-011-9384-7.
Diabetes predisposes to aortic stenosis (AS). We aimed to investigate if diabetes affects the expression of selected coagulation proteins and inflammatory markers in AS valves. Twenty patients with severe AS and concomitant type 2 diabetes mellitus (DM) and 40 well-matched patients without DM scheduled for valve replacement were recruited. Valvular tissue factor (TF), TF pathway inhibitor (TFPI), prothrombin, C-reactive protein (CRP) expression were evaluated by immunostaining and TF, prothrombin, and CRP transcripts were analyzed by real-time PCR. DM patients had elevated plasma CRP (9.2 [0.74-51.9] mg/l vs. 4.7 [0.59-23.14] mg/l, p = 0.009) and TF (293.06 [192.32-386.12] pg/ml vs. 140 [104.17-177.76] pg/ml, p = 0.003) compared to non-DM patients. In DM group, TF-, TFPI-, and prothrombin expression within valves was not related to demographics, body mass index, and concomitant diseases, whereas increased expression related to DM was found for CRP on both protein (2.87 [0.5-9]% vs. 0.94 [0-4]%, p = 0.01) and transcript levels (1.3 ± 0.61 vs. 0.22 ± 0.43, p = 0.009). CRP-positive areas were positively correlated with mRNA TF (r = 0.84, p = 0.036). Diabetes mellitus is associated with enhanced inflammation within AS valves, measured by CRP expression, which may contribute to faster AS progression.
糖尿病易患主动脉瓣狭窄（AS）。我们旨在研究糖尿病是否会影响 AS 瓣膜中选定的凝血蛋白和炎症标志物的表达。招募了 20 名患有严重 AS 且合并 2 型糖尿病（DM）的患者和 40 名具有匹配 DM 的患者，用于瓣膜置换术。通过免疫染色评估组织因子（TF）、TF 途径抑制剂（TFPI）、凝血酶原、C 反应蛋白（CRP）的表达，并通过实时 PCR 分析 TF、凝血酶原和 CRP 转录本。DM 患者的血浆 CRP（9.2[0.74-51.9]mg/l 比 4.7[0.59-23.14]mg/l，p=0.009）和 TF（293.06[192.32-386.12]pg/ml 比 140[104.17-177.76]pg/ml，p=0.003）均升高。在 DM 组中，瓣膜内 TF、TFPI 和凝血酶原的表达与人口统计学、体重指数和合并症无关，而 CRP 的表达与 DM 相关，蛋白（2.87[0.5-9]%比 0.94[0-4]%，p=0.01）和转录水平（1.3±0.61 比 0.22±0.43，p=0.009）均升高。CRP 阳性区域与 mRNA TF 呈正相关（r=0.84，p=0.036）。糖尿病与 AS 瓣膜内炎症增强有关，这可以通过 CRP 表达来衡量，这可能导致 AS 进展更快。
