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血清脂肪细胞脂肪酸结合蛋白水平与 2 型糖尿病女性外周动脉疾病相关,但与男性无关。

Serum adipocyte fatty acid-binding protein levels are associated with peripheral arterial disease in women, but not men, with type 2 diabetes mellitus.

机构信息

Endocrinology Department, 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Key Laboratory of Hormone and Development (Ministry of Health), Metabolic Disease Hospital of Tianjin Medical University, Tianjin, China.

出版信息

J Diabetes. 2018 Jun;10(6):478-486. doi: 10.1111/1753-0407.12549. Epub 2017 May 14.

Abstract

BACKGROUND

Adipocyte fatty acid-binding protein (A-FABP) has been recognized as an important player in macrophage cholesterol trafficking and inflammation, and may promote the development of atherosclerosis. To further elucidate the role of A-FABP in atherosclerosis in diabetes, we investigated the relationship between serum A-FABP concentrations and peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM).

METHODS

In all, 488 inpatients with T2DM were enrolled in the study (254 men, 234 women; mean (±SD) age 57.3 ± 13.0 years). The severity of peripheral arterial stenosis was assessed by ultrasound examination. Serum A-FABP concentrations were determined by ELISA.

RESULTS

Serum A-FABP concentrations were significantly higher in patients with than without PAD (8.0 ± 3.3 vs 6.2 ± 1.6 ng/mL, respectively; P < 0.05). Interestingly, there was an obvious gender-related difference in PAD patients with T2DM, with the stenosis rate being higher for female than male T2DM patients in the third A-FABP tertile. Logistic regression analysis revealed that serum A-FABP concentrations were an independent risk factor for PAD in female T2DM patients (odds ratio 1.890, 95% confidence interval 1.041-3.432; P = 0.036), but not in male T2DM patients. Correlation analyses revealed that A-FABP concentrations were correlated with body mass index (BMI), diastolic blood pressure, urinary microalbumin, and serum creatinine in male patients, and with BMI, duration of T2DM, fasting blood glucose, and serum creatinine in female patients.

CONCLUSIONS

Serum A-FABP concentrations are closely associated with PAD in Chinese women with T2DM. The study findings suggest that A-FABP may be a more specific marker of PAD in diabetic women than men.

摘要

背景

脂肪细胞脂肪酸结合蛋白(A-FABP)已被认为是巨噬细胞胆固醇转运和炎症的重要参与者,并且可能促进动脉粥样硬化的发展。为了进一步阐明 A-FABP 在糖尿病患者动脉粥样硬化中的作用,我们研究了 2 型糖尿病(T2DM)患者血清 A-FABP 浓度与外周动脉疾病(PAD)之间的关系。

方法

共纳入 488 例 T2DM 住院患者(男 254 例,女 234 例;平均年龄(±标准差)57.3±13.0 岁)。采用超声检查评估外周动脉狭窄程度。通过 ELISA 法测定血清 A-FABP 浓度。

结果

与无 PAD 的患者相比,有 PAD 的患者血清 A-FABP 浓度显著升高(分别为 8.0±3.3 与 6.2±1.6 ng/mL,P<0.05)。有趣的是,在有 T2DM 的 PAD 患者中,血清 A-FABP 浓度存在明显的性别相关差异,在第 3 个 A-FABP 三分位数中,女性 T2DM 患者的狭窄率高于男性。Logistic 回归分析显示,血清 A-FABP 浓度是女性 T2DM 患者 PAD 的独立危险因素(比值比 1.890,95%置信区间 1.041-3.432;P=0.036),但不是男性 T2DM 患者的危险因素。相关分析显示,男性患者中 A-FABP 浓度与体重指数(BMI)、舒张压、尿微量白蛋白和血清肌酐相关,女性患者中与 BMI、T2DM 病程、空腹血糖和血清肌酐相关。

结论

血清 A-FABP 浓度与中国女性 T2DM 患者的 PAD 密切相关。研究结果表明,与男性相比,A-FABP 可能是女性糖尿病患者 PAD 的更特异标志物。

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