Department of Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Endocr J. 2012;59(12):1085-91. doi: 10.1507/endocrj.ej12-0192. Epub 2012 Aug 3.
The present study was undertaken to determine whether acute exercise load alters serum retinol-binding protein 4 (RBP4) and numbers of endothelial progenitor cells (EPC) in diabetic subjects. Sixty-two subjects with type 2 diabetes mellitus were enrolled in the present study. They were 50 males and 12 females with the ages of 65.1±8.1 (mean ± SD) years. Cardio-pulmonary exercise stress test (CPX) was carried out, and the numbers of EPC and serum RBP4 levels before and after the CPX were measured. RBP4 is a cytokine synthesized in hepatocytes, white adipose tissues and skeletal muscles, and serum RBP4 was determined by ELISA. EPC was determined as CD34(+)/133(+) cells by FACS. The subjects were subgrouped into two groups with or without nephropathy. Serum RBP4 levels promptly increased from 48.2±4.3 (mean±SEM) to 54.3±4.2 μg/mL after the CPX (mean exercise time of 8 min) in the diabetic subjects without nephropathy (p=0.0006), but did not in those with nephropathy. There was a positive correlation between changes in serum RBP4 during the exercise and estimated glomerular filtration rate (r=0.30, p=0.018). Also, an acute exercise load promptly increased the number of EPCs in the diabetic subjects with and without nephropathy. These findings suggest that a prompt increase in exercise-induced RBP4 is retarded by progression of nephropathy, and that an exercise-induced mobilization of EPCs could maintain endothelial cells in diabetic subjects.
本研究旨在探讨急性运动负荷是否改变 2 型糖尿病患者血清视黄醇结合蛋白 4（RBP4）和内皮祖细胞（EPC）的数量。本研究纳入了 62 例 2 型糖尿病患者，其中男 50 例，女 12 例，年龄 65.1±8.1（均数±标准差）岁。进行心肺运动应激试验（CPX），并测量 CPX 前后 EPC 数量和血清 RBP4 水平。RBP4 是一种在肝细胞、白色脂肪组织和骨骼肌中合成的细胞因子，采用 ELISA 法测定血清 RBP4。EPC 通过 FACS 作为 CD34(+)/133(+)细胞确定。将患者分为无肾病和有肾病两组。在无肾病的糖尿病患者中，血清 RBP4 水平在 CPX（平均运动时间 8 分钟）后即刻从 48.2±4.3（均数±SEM）升高至 54.3±4.2μg/ml（p=0.0006），但在有肾病的患者中则没有升高。运动过程中血清 RBP4 的变化与估算肾小球滤过率（r=0.30，p=0.018）呈正相关。此外，急性运动负荷可即刻增加无肾病和有肾病的糖尿病患者的 EPC 数量。这些发现表明，肾病进展会延迟运动引起的 RBP4 的快速增加，而运动引起的 EPC 动员可维持糖尿病患者的内皮细胞。
