Zhang Jun, Liu Yuan-yuan, Sun Hui-ling, Li Shan, Xiong Hai-rong, Yang Zhan-qiu, Xiang Guang-da, Jiang Xiao-jing
Graduate School, Southern Medical University, Guangzhou, Guangdong, China (mainland).
State Key Laboratory of Virology, Institute of Medical Virology, School of Medicine, Wuhan University, Wuhan, Hubei, China (mainland).
Med Sci Monit. 2015 Dec 30;21:4102-10. doi: 10.12659/msm.896071.
BACKGROUND At present, whether human cytomegalovirus (HCMV) infection is associated with type 2 diabetes mellitus (T2DM) is debatable. The effect of active HCMV infection on glucose regulation has been poorly studied. Although HCMV infection is correlated with atherosclerosis in cardiovascular disease, the role of HCMV infection in the development of diabetic atherosclerosis in T2DM is unclear and is usually neglected by endocrinologists. The aim of this study was to assess the effects of HCMV infection on glucose regulation and the development of diabetic atherosclerosis in T2DM patients. MATERIAL AND METHODS A total of 222 hospitalized T2DM patients were enrolled. Nested polymerase chain reactions were used to detect HCMV DNA extracted from peripheral blood leukocytes. Quantitative real-time PCR was used to determine viral load. HCMV IgG antibody concentrations were analyzed by chemiluminescence immunoassay. RESULTS HCMV active infection, viral load, and HCMV IgG titers were not correlated with glucose regulation. Binary logistic regression demonstrated that the highest quartile of HCMV IgG concentration (>500 U/ml) was correlated with the incidence of diabetic atherosclerosis (OR: 8.0, 95%CI: 2.3-27.2), and that titer >127 U/ml of HCMV IgG is an independent predictor for the development of diabetic atherosclerosis in T2DM patients (OR: 4.6, 95%CI: 1.9-11.3) after adjustment for all potential confounding factors. CONCLUSIONS Active HCMV infection is unlikely to influence glucose regulation in T2DM. However, HCMV IgG titers are associated with the incidence of diabetic atherosclerosis, and titer >127 U/ml of HCMV IgG might be an independent risk factor for the development of diabetic atherosclerosis in T2DM patients.
背景 目前，人类巨细胞病毒（HCMV）感染是否与2型糖尿病（T2DM）相关仍存在争议。HCMV活动性感染对血糖调节的影响研究较少。尽管HCMV感染与心血管疾病中的动脉粥样硬化相关，但HCMV感染在T2DM患者糖尿病性动脉粥样硬化发展中的作用尚不清楚，且通常被内分泌学家忽视。本研究的目的是评估HCMV感染对T2DM患者血糖调节及糖尿病性动脉粥样硬化发展的影响。
材料与方法 共纳入222例住院T2DM患者。采用巢式聚合酶链反应检测外周血白细胞中提取的HCMV DNA。采用定量实时PCR测定病毒载量。通过化学发光免疫分析法分析HCMV IgG抗体浓度。
结果 HCMV活动性感染、病毒载量和HCMV IgG滴度与血糖调节无关。二元逻辑回归显示，HCMV IgG浓度最高四分位数（>500 U/ml）与糖尿病性动脉粥样硬化的发生率相关（比值比：8.0，95%置信区间：2.3 - 27.2），并且在调整所有潜在混杂因素后，HCMV IgG滴度>127 U/ml是T2DM患者糖尿病性动脉粥样硬化发展的独立预测因素（比值比：4.6，95%置信区间：1.9 - 11.3）。
结论 HCMV活动性感染不太可能影响T2DM患者的血糖调节。然而，HCMV IgG滴度与糖尿病性动脉粥样硬化的发生率相关，且HCMV IgG滴度>127 U/ml可能是T2DM患者糖尿病性动脉粥样硬化发展的独立危险因素。
