2型糖尿病患者血清载脂蛋白A-V水平、氧化应激及炎症生物标志物与高甘油三酯血症的关系
Relationship of Serum Apolipoprotein A-V Levels, Oxidative Stress and Inflammatory Biomarkers with Hypertriglyceridemia in Type 2 Diabetes Mellitus.
作者信息
Sharma Devesh, Garg Seema, Mehndiratta Mohit, V Madhu S, Puri Dinesh
机构信息
Departement of Biochemistry, University College of Medical Sciences and GTB Hospital, University of Delhi, Delhi, India.
Department of Medicine, University College of Medical Sciences and GTB Hospital, University of Delhi, Delhi, India.
出版信息
Int J Endocrinol Metab. 2017 Apr 22;15(2):e44805. doi: 10.5812/ijem.44805. eCollection 2017 Apr.
BACKGROUND
Serum levels of triglycerides (TGs) are often found to be raised in type 2 diabetes mellitus (T2DM). TG levels ≥ 2.2 mM, systemic inflammation and oxidative stress (OS) are known to increase the risk of incident cardiovascular disease (CVD) substantially. In recent years, apolipoprotein A-V (Apo A-V protein) has attracted considerably as a modulator of circulating TG levels.
OBJECTIVES
The study was conducted in order to evaluate the levels of Apo A - V proteins and markers of inflammation and OS in patients of T2DM with and without hypertriglyceridemia (HTG) and also to assess correlation between them.
METHODS
T2DM patients were categorized into two groups of 40 participants, according to criteria for risk of CVD: group 1/ controls (TG ≤ 1.65 mM, n = 40) and group 2/ cases (TG ≥ 2.2 mM, n = 40). Despite the routine investigations, serum levels of Apo A-V, interleukin-6 (IL-6) and Insulin were estimated using ELISA, free fatty acids (FFA) with fluorometric assay and malondialdehyde (MDA) was measured using a spectrophotometer. Comparison of levels and correlation between variables was carried out with appropriate statistical tools.
RESULTS
Serum Apo A-V protein levels were found significantly lower (P = 0.04) and MDA was significantly higher (P = 0.049) in cases. MDA correlated with TG levels positively (P = 0.000) and negatively with high density lipoproteins (HDL) (P = 0.000). However Apo A-V protein levels did not correlate with TG levels (P = 0.819, r = -0.027), IL-6 (r = 0.135, P = 0.269), FFA (r = 0.128, P = 0.277) and MDA (r = -0.217, P = 0.073). IL-6 levels significantly and positively correlated with HOMA-IR (r = 0.327, P = 0.004) in the all patients.
CONCLUSIONS
In patients of T2DM, low levels of Apo A-V are associated with HTG, indicating that Apo A-V is linked with TG metabolism. Burden of oxidative stress is greater in HTG of T2DM as is evident from MDA levels and its correlation with TG levels. Since oxidative stress is an important patho-physiological basis which increases the risk of CVD in patients of T2DM with HTG. Further studies are required in order to explore the possible role of Apo A-V in TG metabolism in diabetes.
背景
2型糖尿病（T2DM）患者的血清甘油三酯（TG）水平常常升高。已知TG水平≥2.2 mM、全身炎症和氧化应激（OS）会大幅增加心血管疾病（CVD）的发病风险。近年来，载脂蛋白A-V（Apo A-V蛋白）作为循环TG水平的调节剂备受关注。
目的
本研究旨在评估伴有和不伴有高甘油三酯血症（HTG）的T2DM患者的Apo A-V蛋白水平以及炎症和OS标志物，并评估它们之间的相关性。
方法
根据CVD风险标准，将T2DM患者分为两组，每组40名参与者：第1组/对照组（TG≤1.65 mM，n = 40）和第2组/病例组（TG≥2.2 mM，n = 40）。除常规检查外，采用酶联免疫吸附测定法（ELISA）检测血清Apo A-V、白细胞介素-6（IL-6）和胰岛素水平，采用荧光测定法检测游离脂肪酸（FFA）水平，采用分光光度计测量丙二醛（MDA）水平。使用适当的统计工具对变量水平进行比较并分析相关性。
结果
病例组血清Apo A-V蛋白水平显著降低（P = 0.04），MDA水平显著升高（P = 0.049）。MDA与TG水平呈正相关（P = 0.000），与高密度脂蛋白（HDL）呈负相关（P = 0.000）。然而，Apo A-V蛋白水平与TG水平（P = 0.819，r = -0.027）、IL-6（r = 0.135，P = 0.269）、FFA（r = 0.128，P = 0.277）和MDA（r = -0.217，P = 0.073）均无相关性。在所有患者中，IL-6水平与稳态模型评估的胰岛素抵抗（HOMA-IR）呈显著正相关（r = 0.327，P = 0.004）。
结论
在T2DM患者中，低水平的Apo A-V与HTG相关，表明Apo A-V与TG代谢有关。从MDA水平及其与TG水平的相关性可以看出，T2DM合并HTG患者的氧化应激负担更大。由于氧化应激是增加T2DM合并HTG患者CVD风险的重要病理生理基础，因此需要进一步研究以探索Apo A-V在糖尿病TG代谢中的可能作用。
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