日本2型糖尿病患者循环白细胞亚型计数与颈动脉内膜中层厚度之间的关联。
Association between circulating leukocyte subtype counts and carotid intima-media thickness in Japanese subjects with type 2 diabetes.
作者信息
Matsumura Takeshi, Taketa Kayo, Motoshima Hiroyuki, Senokuchi Takafumi, Ishii Norio, Kinoshita Hiroyuki, Fukuda Kazuki, Yamada Sarie, Kukidome Daisuke, Kondo Tatsuya, Hisada Aya, Katoh Takahiko, Shimoda Seiya, Nishikawa Takeshi, Araki Eiichi
机构信息
Department of Metabolic Medicine, Kumamoto University, Kumamoto, Japan.
出版信息
Cardiovasc Diabetol. 2013 Dec 27;12:177. doi: 10.1186/1475-2840-12-177.
BACKGROUND
An increased leukocyte count is an independent risk factor for cardiovascular events, but the association between leukocyte subtype counts and carotid atherosclerosis in patients with diabetes has not been determined. We therefore investigated the correlation between leukocyte subtype counts and intima-media thickness of the common carotid artery (CCA-IMT) in subjects with type 2 diabetes.
METHODS
This cross-sectional study involved 484 in-patients with type 2 diabetes (282 males and 202 females), who were hospitalized for glycemic control and underwent carotid ultrasonography at Kumamoto University Hospital between 2005 and 2011. Mean and maximum CCA-IMT was measured by high-resolution B-mode ultrasonography.
RESULTS
Univariate analyses revealed that mean CCA-IMT was positively correlated with age, systolic blood pressure, brachial-ankle pulse wave velocity (PWV), urinary albumin excretion and duration of diabetes, but was negatively correlated with diastolic blood pressure and fasting plasma glucose. Maximum CCA-IMT was positively and negatively correlated with the same factors as mean CCA-IMT except for fasting plasma glucose. Mean CCA-IMT was positively correlated with total leukocyte (r = 0.124, p = 0.007), monocyte (r = 0.373, p < 0.001), neutrophil (r = 0.139, p = 0.002) and eosinophil (r = 0.107, p = 0.019) counts. Maximum CCA-IMT was positively correlated with total leukocyte (r = 0.154, p < 0.001), monocyte (r = 0.398, p < 0.001), neutrophil (r = 0.152, p < 0.001) and basophil counts (r = 0.102, p = 0.027). Multiple regression analyses showed that monocyte count, age and PWV were significant and independent factors associated with mean CCA-IMT (adjusted R2 = 0.239, p < 0.001), and that monocyte count, age and urinary albumin excretion were significant and independent factors associated with maximum CCA-IMT (adjusted R2 = 0.277, p < 0.001).
CONCLUSIONS
Monocyte counts were positively correlated with both mean CCA-IMT and maximum CCA-IMT in patients with type 2 diabetes. Monocyte count may be a useful predictor of macrovascular complications in patients with type 2 diabetes.
TRIAL REGISTRATION
Trial registry no: UMIN000003526.
背景
白细胞计数增加是心血管事件的独立危险因素，但糖尿病患者白细胞亚型计数与颈动脉粥样硬化之间的关联尚未明确。因此，我们调查了2型糖尿病患者白细胞亚型计数与颈总动脉内膜中层厚度（CCA-IMT）之间的相关性。
方法
这项横断面研究纳入了484例2型糖尿病住院患者（男性282例，女性202例），他们因血糖控制问题于2005年至2011年期间在熊本大学医院住院，并接受了颈动脉超声检查。通过高分辨率B型超声测量CCA-IMT的平均值和最大值。
结果
单因素分析显示，CCA-IMT平均值与年龄、收缩压、臂踝脉搏波速度（PWV）、尿白蛋白排泄量和糖尿病病程呈正相关，但与舒张压和空腹血糖呈负相关。CCA-IMT最大值与CCA-IMT平均值的相关因素相同，但与空腹血糖无关，呈正相关或负相关。CCA-IMT平均值与总白细胞计数（r = 0.124，p = 0.007）、单核细胞计数（r = 0.373，p < 0.001）、中性粒细胞计数（r = 0.139，p = 0.002）和嗜酸性粒细胞计数（r = 0.107，p = 0.019）呈正相关。CCA-IMT最大值与总白细胞计数（r = 0.154，p < 0.001）、单核细胞计数（r = 0.398，p < 0.001）、中性粒细胞计数（r = 0.152，p < 0.001）和嗜碱性粒细胞计数（r = 0.102，p = 0.027）呈正相关。多元回归分析显示，单核细胞计数、年龄和PWV是与CCA-IMT平均值相关的显著独立因素（调整R2 = 0.239，p < 0.001），单核细胞计数、年龄和尿白蛋白排泄量是与CCA-IMT最大值相关的显著独立因素（调整R2 = 0.277，p < 0.001）。
结论
2型糖尿病患者的单核细胞计数与CCA-IMT平均值和最大值均呈正相关。单核细胞计数可能是2型糖尿病患者大血管并发症的有用预测指标。
试验注册
试验注册号：UMIN000003526。
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