Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 6500017, Japan.
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 6500017, Japan.
Cardiovasc Diabetol. 2017 Aug 8;16(1):96. doi: 10.1186/s12933-017-0577-8.
Previously, we have reported that daily glucose fluctuations could affect coronary plaque vulnerability, but the underlying mechanisms remained unclear. This study sought to investigate the impact of CD14CD16 monocytes on plaque vulnerability, as assessed by virtual histology intravascular ultrasound (VH-IVUS), as well as their relationship to fluctuating glucose levels in patients with asymptomatic coronary artery disease (CAD).
Fifty-one patients with asymptomatic CAD, who were undergoing lipid-lowering therapy and underwent VH-IVUS evaluation for angiographically mild to moderate lesions, were enrolled in the study. Standard VH-IVUS parameters, including the percentage volume of the necrotic core (%NC) within the plaque and the presence of a virtual histology thin-cap fibroatheroma (VH-TCFA), were then evaluated. Additionally, monocyte subsets were assessed by flow cytometry, and daily glucose fluctuations were analyzed by measuring the mean amplitude of glycemic excursion (MAGE).
Among 82 plaques from 22 diabetes mellitus (DM) patients and 29 non-DM patients, 15 VH-TCFAs were identified. CD14CD16 monocyte counts significantly correlated with both %NC and the presence of VH-TCFA (%NC: r = 0.339, p = 0.002; VH-TCFA: p = 0.003). Multivariate logistic regression analysis revealed that CD14CD16 monocyte counts were independently associated with VH-TCFA (odds ratio = 1.029, p = 0.004). Furthermore, CD14CD16 monocyte counts were significantly correlated with the MAGE score in the non-DM patients (r = 0.544, p = 0.005).
CD14CD16 monocyte levels are associated with coronary plaque vulnerability and can serve as a biomarker for VH-TCFA in patients with CAD undergoing lipid-lowering therapy. In patients without DM, glucose fluctuations may alter the balance of monocyte subsets. Trial registration UMIN Registry number: UMIN000021228.
我们之前报道过，每日血糖波动可能会影响冠状动脉斑块的脆弱性，但具体机制尚不清楚。本研究旨在探讨 CD14CD16 单核细胞对无症状性冠状动脉疾病（CAD）患者斑块脆弱性的影响，通过虚拟组织学血管内超声（VH-IVUS）评估，并研究其与波动的血糖水平之间的关系。
本研究纳入了 51 例正在接受降脂治疗且血管造影显示轻度至中度病变的无症状 CAD 患者。评估了标准的 VH-IVUS 参数，包括斑块内坏死核心的百分比体积（%NC）和虚拟组织学薄帽纤维粥样斑块（VH-TCFA）的存在。此外，通过流式细胞术评估单核细胞亚群，通过测量平均血糖波动幅度（MAGE）分析每日血糖波动。
在 22 例糖尿病（DM）患者和 29 例非 DM 患者的 82 个斑块中，发现了 15 个 VH-TCFA。CD14CD16 单核细胞计数与%NC 和 VH-TCFA 的存在均显著相关（%NC：r=0.339，p=0.002；VH-TCFA：p=0.003）。多变量 logistic 回归分析显示，CD14CD16 单核细胞计数与 VH-TCFA 独立相关（比值比=1.029，p=0.004）。此外，在非 DM 患者中，CD14CD16 单核细胞计数与 MAGE 评分显著相关（r=0.544，p=0.005）。
CD14CD16 单核细胞水平与冠状动脉斑块脆弱性相关，可作为降脂治疗的 CAD 患者 VH-TCFA 的生物标志物。在无 DM 患者中，血糖波动可能会改变单核细胞亚群的平衡。
UMIN 注册号：UMIN000021228。
