Vinagre Irene, Sánchez-Quesada José Luis, Sánchez-Hernández Juan, Santos David, Ordoñez-Llanos Jordi, De Leiva Alberto, Pérez Antonio
Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, C/ Mas Casanovas 90, Barcelona 08025, Spain.
Cardiovasc Diabetol. 2014 Feb 4;13:34. doi: 10.1186/1475-2840-13-34.
Type 2 diabetes mellitus (T2D) is associated with higher cardiovascular risk partly related to an increase in inflammatory parameters. The aim of this study was to determine the association of inflammatory biomarkers with low-density lipoprotein (LDL) subfraction phenotype and glycemic control in subjects with T2D and poor glycemic control.
A cross-sectional study was performed comparing 122 subjects with T2D (59 ± 11 years old, body mass index 30.2 ± 5.6 kg/m2) with 54 control subjects. Patients with T2D were classified according to their LDL subfraction phenotype and inflammatory biomarkers (C-reactive protein, Interleukin-6, Interleukin-8, Transforming growth factor β1, Monocyte chemotactic protein 1, Leptin, Adiponectin) were evaluated according to the degree of glycemic control, LDL phenotype and other clinical characteristics. Forty-two subjects with T2D were studied before and after 3 months of improving glycemic control by different strategies.
Patients with T2D had higher C-reactive protein (CRP) and monocyte chemotactic protein-1 (MCP1) levels and lower adiponectin concentration, compared to controls. T2D subjects with body mass index ≥ 30 kg/m2 had higher CRP levels (5.2 ± 4.8 mg/l vs 3.7 ± 4.3 mg/l; p < 0.05). The presence of LDL phenotype B was related to higher levels of transforming growth factor-β1 (TGF-β1) (53.92 ± 52.82 ng/l vs 31.35 ± 33.74 ng/l; p < 0.05) and lower levels of adiponectin (3663 ± 3044 ng/l vs 2723 ± 1776 ng/l; p < 0.05). The reduction of HbA1c from 9.5 ± 1.8% at baseline to 7.4 ± 0.8% was associated with a significant reduction of TGF-β1 (41.86 ± 32.84 ng/l vs 26.64 ± 26.91 ng/l; p = 0.02).
Subjects with T2D, especially those with LDL phenotype B and obesity, have higher levels of inflammatory biomarkers. Improvement of glycemic control reduces TGF-β1 levels, which may contribute partly to its renoprotective role.
2型糖尿病（T2D）与较高的心血管风险相关，部分原因是炎症参数增加。本研究的目的是确定炎症生物标志物与T2D且血糖控制不佳患者的低密度脂蛋白（LDL）亚组分表型及血糖控制之间的关联。
进行了一项横断面研究，将122例T2D患者（59±11岁，体重指数30.2±5.6kg/m²）与54例对照者进行比较。T2D患者根据其LDL亚组分表型进行分类，并根据血糖控制程度、LDL表型及其他临床特征评估炎症生物标志物（C反应蛋白、白细胞介素-6、白细胞介素-8、转化生长因子β1、单核细胞趋化蛋白1、瘦素、脂联素）。42例T2D患者在采用不同策略改善血糖控制3个月前后进行了研究。
与对照组相比，T2D患者的C反应蛋白（CRP）和单核细胞趋化蛋白-1（MCP1）水平较高，脂联素浓度较低。体重指数≥30kg/m²的T2D患者CRP水平较高（5.2±4.8mg/l对3.7±4.3mg/l；p<0.05）。LDL表型B的存在与较高水平的转化生长因子-β1（TGF-β1）（53.92±52.82ng/l对31.35±33.74ng/l；p<0.05）和较低水平的脂联素（3663±3044ng/l对2723±1776ng/l；p<0.05）相关。糖化血红蛋白（HbA1c）从基线时的9.5±1.8%降至7.4±0.8%与TGF-β1的显著降低相关（41.86±32.84ng/l对26.64±26.91ng/l；p=0.02）。
T2D患者，尤其是那些具有LDL表型B和肥胖的患者，炎症生物标志物水平较高。血糖控制的改善降低了TGF-β1水平，这可能部分有助于其肾脏保护作用。
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