空腹血糖受损患者的低度内毒素血症、肠道通透性和血小板活化

Low-grade endotoxemia, gut permeability and platelet activation in patients with impaired fasting glucose.

作者信息

Carnevale R, Pastori D, Nocella C, Cammisotto V, Baratta F, Del Ben M, Angelico F, Sciarretta S, Bartimoccia S, Novo M, Targher G, Violi F

机构信息

Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.

I Medical Clinic, Atherothrombosis Center, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy; Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2017 Oct;27(10):890-895. doi: 10.1016/j.numecd.2017.06.007. Epub 2017 Jun 19.

DOI:10.1016/j.numecd.2017.06.007

PMID:28743559

Abstract

BACKGROUND AND AIM

Impaired fasting glucose (IFG) is associated with an increased risk of cardiovascular disease but the underlying mechanisms are still unclear. Aim of the study was to investigate the interplay between platelet activation, lipopolysaccharides (LPS) and markers of oxidative stress in patients with IFG and control subjects.

METHODS AND RESULTS

We performed a cross-sectional study including 35 patients with IFG and 35 control subjects who were well comparable for age, sex, body mass index and smoking history. Serum levels of LPS, zonulin (a marker of gut permeability), oxidized LDL and plasma levels of soluble P-selectin, were measured. Patients with IFG had significantly higher levels of sP-selectin, LPS, zonulin and oxLDL compared to control subjects. The IFG status (beta coefficient: 0.518, p < 0.001), higher LPS (beta coefficient: 0.352, p = 0.001) and female sex (beta coefficient: 0.179, p = 0.042) were independently associated with higher sP-selectin; in addition, oxLDL was positively associated with sP-selectin (r = 0.530, p < 0.001) and LPS (r = 0.529, p = 0.001). In IFG patients, we found a significant association between LPS and zonulin (r = 0.521, p = 0.001); this association was confirmed at multivariable analysis (beta coefficient: 0.512, p = 0.007).

CONCLUSION

Our study provides evidence that patients with IFG have increased platelet activation, and suggests LPS as a potential trigger for in vivo platelet activation in this patient population.

摘要

背景与目的

空腹血糖受损（IFG）与心血管疾病风险增加相关，但其潜在机制仍不清楚。本研究的目的是调查IFG患者与对照受试者中血小板活化、脂多糖（LPS）和氧化应激标志物之间的相互作用。

方法与结果

我们进行了一项横断面研究，纳入35例IFG患者和35例对照受试者，他们在年龄、性别、体重指数和吸烟史方面具有良好的可比性。检测血清LPS水平、连蛋白（肠道通透性标志物）、氧化型低密度脂蛋白（oxLDL）以及血浆可溶性P-选择素水平。与对照受试者相比，IFG患者的可溶性P-选择素、LPS、连蛋白和oxLDL水平显著更高。IFG状态（β系数：0.518，p<0.001）、较高的LPS水平（β系数：0.352，p=0.001）和女性性别（β系数：0.179，p=0.042）与较高的可溶性P-选择素独立相关；此外，oxLDL与可溶性P-选择素呈正相关（r=0.530，p<0.001），与LPS呈正相关（r=0.529，p=0.001）。在IFG患者中，我们发现LPS与连蛋白之间存在显著关联（r=0.521，p=0.001）；多变量分析证实了这种关联（β系数：0.512，p=0.007）。