Lv Yaya, Zhang Yaqiong, Shi Weiya, Liu Juxiang, Li Yonghong, Zhou Zubang, He Qijuan, Wei Suhong, Liu Jing, Quan Jinxing
Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China; Key Lab of Endocrine and Metabolic Diseases of Gansu Province, Lanzhou, China.
Gansu University of Traditional Chinese Medicine, Lanzhou, China.
Am J Med Sci. 2017 May;353(5):433-438. doi: 10.1016/j.amjms.2017.02.004. Epub 2017 Feb 22.
Proinflammatory conditions induced by circulating factors in diabetes play a pivotal role in endothelial dysfunction and related vascular complications. Endothelial cell-specific molecule-1 or endocan is a dermatan sulfate proteoglycan secreted primarily by the vascular endothelium. Although endocan has been shown to be a potential biomarker in coronary heart disease, its role in the pathogenesis of atherosclerosis (AS) in diabetes remains unclear. In this study, we investigated the correlation between serum endocan levels and subclinical AS in patients with type 2 diabetes mellitus (T2DM).
Patients (n = 69) with T2DM were included. All the patients were stratified based on the absence (n = 42) or presence (n = 27) of subclinical AS. Healthy subjects (n = 28) served as controls. Serum levels of endocan, fasting blood glucose, glycosylated hemoglobin A1, high-sensitivity C-reactive protein and carotid intima-media thickness (cIMT) were measured.
Endocan levels were significantly elevated in both the T2DM (0.89 ± 0.28ng/mL) and T2DM with subclinical AS (1.20 ± 0.33ng/mL) groups relative to the control group (0.68 ± 0.24ng/mL) (P < 0.05 for all). Endocan levels were also positively correlated with glycosylated hemoglobin A1, fasting blood glucose and cIMT (r = 0.292, P = 0.004; r = 0.224, P = 0.027 and r = 0.496, P < 0.001, respectively). In addition, endocan levels were independently associated with cIMT (β = 0.220, t = 5.816, P = 0.000) and were a significant risk factor for T2DM with subclinical AS (odds ratio = 1.98, 95% CI: 1.43-2.73, P < 0.001).
These findings suggest that serum endocan levels may be a useful biomarker for the early diagnosis of subclinical AS in patients with T2DM.
糖尿病中循环因子诱导的促炎状态在内皮功能障碍及相关血管并发症中起关键作用。内皮细胞特异性分子-1或内皮炎相关分子是一种主要由血管内皮分泌的硫酸皮肤素蛋白聚糖。尽管内皮炎相关分子已被证明是冠心病的潜在生物标志物，但其在糖尿病动脉粥样硬化（AS）发病机制中的作用仍不清楚。在本研究中，我们调查了2型糖尿病（T2DM）患者血清内皮炎相关分子水平与亚临床AS之间的相关性。
纳入T2DM患者（n = 69）。所有患者根据是否存在亚临床AS分为无亚临床AS组（n = 42）和有亚临床AS组（n = 27）。健康受试者（n = 28）作为对照。测量血清内皮炎相关分子水平、空腹血糖、糖化血红蛋白A1、高敏C反应蛋白和颈动脉内膜中层厚度（cIMT）。
相对于对照组（0.68±0.24ng/mL），T2DM组（0.89±0.28ng/mL）和有亚临床AS的T2DM组（1.20±0.33ng/mL）的内皮炎相关分子水平均显著升高（均P < 0.05）。内皮炎相关分子水平还与糖化血红蛋白A1、空腹血糖和cIMT呈正相关（r = 0.292，P = 0.004；r = 0.224，P = 0.027；r = 0.496，P < 0.001）。此外，内皮炎相关分子水平与cIMT独立相关（β = 0.220，t = 5.816，P = 0.000），并且是有亚临床AS的T2DM的显著危险因素（比值比 = 1.98，95%可信区间：1.43 - 2.73，P < 0.001）。
这些发现表明，血清内皮炎相关分子水平可能是T2DM患者亚临床AS早期诊断的有用生物标志物。
