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1型和2型糖尿病急性高血糖危象期间的炎症和止血性心血管风险标志物

The Inflammatory and Hemostatic Cardiovascular Risk Markers During Acute Hyperglycemic Crisis in Type 1 and Type 2 Diabetes.

作者信息

Popovic Dragana, Lalic Katarina, Jotic Aleksandra, Milicic Tanja, Bogdanovic Jelena, Đorđevic Maja, Stankovic Sanja, Jeremic Veljko, Lalic Nebojsa M

机构信息

Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Emergency Center, Clinical Centar of Serbia, Clinical Center of Serbia, Belgrade, Serbia.

出版信息

J Med Biochem. 2019 Mar 3;38(2):126-133. doi: 10.2478/jomb-2018-0024. eCollection 2019 Apr.

Abstract

BACKGROUND

We analyzed cardiovascular inflammatory (C-reactive protein (CRP), interleukin 6 (IL-6)), haemostatic (homocysteine) risk markers in lean and obese patients at admission and acute hyperglicemic crisis (AHC) resolving, involving diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).

METHODS

In that context, we included group A: N = 20 obese, B: N=20 lean patients with DKA; C: N = l0 obese, D: N=10 lean patients with HHS; E: N = 15 obese, F: N=15 lean controls. CRP IL-6, homocysteine were determined by ELISA.

RESULTS

Our results showed that CRP IL-6, and homocysteine levels decreased in all groups: (A: p<0.001; B: p<0.001, C: p<0.05; D: p<0.001 mg/L), (A: p<0.001 B: p<0.001, C: p<0.001, D: p<0.01 pg/mL), (A: p<0.001, B: p <0.001; C: p<0.05, D: p=0.001 μmol/L), respectively, at resolving AHC. However, CRP persisted higher (p<0.001, p<0.01), IL-6 lower (p<0.05, p<0.001), while homocysteine levels turned out to be similar to controls.

CONCLUSIONS

AHC is associated with increased inflammatory and hemostatic cardiovascular risk markers. Also, insulin therapy in AHC has had more pronounced favorable effect on IL-6 and homocystein than on CRP.

摘要

背景

我们分析了肥胖和消瘦患者入院时以及急性高血糖危象(AHC,包括糖尿病酮症酸中毒(DKA)和高渗高血糖状态(HHS))缓解时的心血管炎症(C反应蛋白(CRP)、白细胞介素6(IL-6))、止血(同型半胱氨酸)风险标志物。

方法

在此背景下,我们纳入了A组:20例肥胖的DKA患者;B组:20例消瘦的DKA患者;C组:10例肥胖的HHS患者;D组:10例消瘦的HHS患者;E组:15例肥胖对照者;F组:15例消瘦对照者。通过酶联免疫吸附测定法测定CRP、IL-6、同型半胱氨酸。

结果

我们的结果显示,所有组中的CRP、IL-6和同型半胱氨酸水平均下降:在AHC缓解时,分别为(A组:p<0.001;B组:p<0.001,C组:p<0.05;D组:p<0.001 mg/L),(A组:p<0.001,B组:p<0.001,C组:p<0.001,D组:p<0.01 pg/mL),(A组:p<0.001,B组:p<0.001;C组:p<0.05,D组:p=0.001 μmol/L)。然而,CRP仍较高(p<0.001,p<0.01),IL-6较低(p<0.05,p<0.001),而同型半胱氨酸水平与对照者相似。

结论

AHC与炎症和止血性心血管风险标志物增加有关。此外,AHC中的胰岛素治疗对IL-6和同型半胱氨酸的有利影响比对CRP更明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91df/6410996/cfbf7bb5e1b3/jomb-38-126-g001.jpg

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