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血清chemerin和高敏C反应蛋白作为埃及2型糖尿病患者亚临床动脉粥样硬化的标志物

Serum chemerin and high-sensitivity C reactive protein as markers of subclinical atherosclerosis in Egyptian patients with type 2 diabetes.

作者信息

Lachine Nagwa A, Elnekiedy Abdel Aziz, Megallaa Magdy Helmy, Khalil Gihane I, Sadaka Mohamed A, Rohoma Kamel H, Kassab Heba S

机构信息

Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Department of Diagnostic Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

出版信息

Ther Adv Endocrinol Metab. 2016 Apr;7(2):47-56. doi: 10.1177/2042018816637312. Epub 2016 Mar 10.

Abstract

CONTEXT

Chemerin is one of the adipokines that regulate fat metabolism. High-sensitivity C-reactive protein (hs-CRP) may be considered as a cardiovascular risk predictor. Measuring intima-media thickness of the CCA (C-IMT) is a well-evidenced tool for the detection of early stages of atherosclerosis. We aimed here to study both serum chemerin and hs-CRP as markers of subclinical atherosclerosis in Egyptian patients with type 2 diabetes, who are angiographically free of coronary artery disease (CAD).

SUBJECTS AND METHODS

This cross-sectional study was conducted on 180 subjects divided into two groups: Group A included 90 type 2 diabetic patients without CAD and group B including 90 nondiabetic control subjects. All study subjects were having normal coronary angiography. Serum chemerin, homeostasis model assessment for insulin resistance (HOMA-IR), glycated haemoglobin (HbA1c), lipid profile, hs-CRP as well as C-IMT were assessed in all study subjects.

RESULTS

There was a statistically significant difference between the 2 groups regarding serum chemerin level, HOMA-IR, hs-CRP and C-IMT; being higher in the diabetic patients than in the control group (p = 0.006, 0.024, 0.040 and <0.001, respectively). There was positive correlation between serum chemerin level and waist-to-hip ratio (WHR), HOMA-IR, hs-CRP and C-IMT. Carotid intima-media thickness was positively correlated with patients' WHR, blood pressure, HbA1c, diabetes duration as well as hs-CRP, and negatively correlated with ankle-brachial index (ABI). Linear regression analysis showed that HbA1c, serum chemerin and hs-CRP were independently affecting C-IMT. Serum hs-CRP was positively correlated with HbA1c and HOMA-IR (p = 0.006 and 0.032, respectively), and negatively correlated with HDL-cholesterol level (p = 0.018).

CONCLUSION

Both serum chemerin and hs-CRP could be considered as markers of subclinical atherosclerosis, and hence, may be utilized for the early detection of macrovascular disease, in Egyptian patients with type 2 diabetes.

摘要

背景

chemerin是调节脂肪代谢的脂肪因子之一。高敏C反应蛋白(hs-CRP)可被视为心血管疾病风险预测指标。测量颈总动脉内膜中层厚度(C-IMT)是检测动脉粥样硬化早期阶段的一种有充分证据的工具。我们的目的是研究血清chemerin和hs-CRP作为埃及2型糖尿病患者亚临床动脉粥样硬化标志物的情况,这些患者经血管造影显示无冠状动脉疾病(CAD)。

对象与方法

本横断面研究共纳入180名受试者,分为两组:A组包括90名无CAD的2型糖尿病患者,B组包括90名非糖尿病对照受试者。所有研究对象冠状动脉造影均正常。对所有研究对象评估血清chemerin、胰岛素抵抗稳态模型评估(HOMA-IR)、糖化血红蛋白(HbA1c)、血脂谱、hs-CRP以及C-IMT。

结果

两组在血清chemerin水平、HOMA-IR、hs-CRP和C-IMT方面存在统计学显著差异;糖尿病患者的这些指标高于对照组(p分别为0.006、0.024、0.040和<0.001)。血清chemerin水平与腰臀比(WHR)、HOMA-IR、hs-CRP和C-IMT呈正相关。颈动脉内膜中层厚度与患者的WHR、血压、HbA1c、糖尿病病程以及hs-CRP呈正相关,与踝臂指数(ABI)呈负相关。线性回归分析显示,HbA1c、血清chemerin和hs-CRP独立影响C-IMT。血清hs-CRP与HbA1c和HOMA-IR呈正相关(p分别为0.006和0.032),与高密度脂蛋白胆固醇水平呈负相关(p = 0.018)。

结论

在埃及2型糖尿病患者中,血清chemerin和hs-CRP均可被视为亚临床动脉粥样硬化的标志物,因此可用于早期检测大血管疾病。

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