Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Cardiovasc Diabetol. 2012 Jul 18;11:84. doi: 10.1186/1475-2840-11-84.
Inflammation plays an important role in coronary artery disease from the initiation of endothelial dysfunction to plaque formation to final rupture of the plaque. In this study, we investigated the potential pathophysiological and clinical relevance of novel cytokines secreted from various cells including adipocytes, endothelial cells, and inflammatory cells, in predicting coronary artery disease (CAD) in asymptomatic subjects with type 2 diabetes mellitus.
We enrolled a total of 70 asymptomatic type 2 diabetic patients without a documented history of cardiovascular disease, and determined serum levels of chemerin, omentin-1, YKL-40, and sCD26. We performed coronary computed tomographic angiography (cCTA) in all subjects, and defined coronary artery stenosis ≥ 50 % as significant CAD in this study.
Subjects were classified into two groups: patients with suspected coronary artery stenosis on cCTA (group I, n = 41) and patients without any evidence of stenosis on cCTA (group II, n = 29). Group I showed significantly higher YLK-40 levels and lower HDL-C levels than group II (p = 0.038, 0.036, respectively). Levels of chemerin, omentin-1, and sCD26 were not significantly different between the two groups. Serum YKL-40 levels were positively correlated with systolic/diastolic BP, fasting/postprandial triglyceride levels, and Framingham risk score. Furthermore, YKL-40 levels showed moderate correlation with the degree of coronary artery stenosis and the coronary artery calcium score determined from cCTA. In multivariate logistic analysis, after adjusting for age, gender, smoking history, hypertension, and LDL-cholesterol, YLK-40 levels showed only borderline significance.
YKL-40, which is secreted primarily from inflammatory cells, was associated with several CVD risk factors and was elevated in type 2 diabetic patients with suspected coronary artery stensosis on cCTA. These results suggest the possibility that the inflammatory biomarker YKL-40 might be associated with coronary artery disease in asymptomatic patients with type 2 diabetes mellitus.
炎症在从内皮功能障碍的发生到斑块形成再到斑块最终破裂的整个冠状动脉疾病过程中起着重要作用。在这项研究中，我们研究了来自脂肪细胞、内皮细胞和炎性细胞等各种细胞分泌的新型细胞因子在预测无症状 2 型糖尿病患者的冠状动脉疾病（CAD）方面的潜在病理生理和临床相关性。
我们共纳入了 70 名无心血管疾病病史的无症状 2 型糖尿病患者，测定了血清趋化素、网膜素-1、YKL-40 和 sCD26 水平。所有患者均行冠状动脉计算机断层血管造影（cCTA）检查，本研究中定义冠状动脉狭窄≥50%为有意义的 CAD。
患者分为两组：cCTA 显示可疑冠状动脉狭窄的患者（组 I，n=41）和 cCTA 无任何狭窄证据的患者（组 II，n=29）。组 I 的 YKL-40 水平显著高于组 II，而高密度脂蛋白胆固醇（HDL-C）水平显著低于组 II（p=0.038，0.036）。两组之间的趋化素、网膜素-1 和 sCD26 水平无显著差异。血清 YKL-40 水平与收缩压/舒张压、空腹/餐后甘油三酯水平和弗雷明汉风险评分呈正相关。此外，YKL-40 水平与 cCTA 确定的冠状动脉狭窄程度和冠状动脉钙评分呈中度相关。在多元逻辑回归分析中，在校正年龄、性别、吸烟史、高血压和 LDL-胆固醇后，YKL-40 水平仅具有边缘显著性。
YKL-40 主要由炎性细胞分泌，与多种 CVD 危险因素相关，在 cCTA 显示疑似冠状动脉狭窄的 2 型糖尿病患者中升高。这些结果表明，炎症生物标志物 YKL-40 可能与无症状 2 型糖尿病患者的冠状动脉疾病相关。
Zotero 插件