载脂蛋白 C-III 转移酶活性与控制不佳的 2 型糖尿病患者的颈动脉内膜中层厚度无关。

CETP activity is not associated with carotid intima-media thickness in patients with poorly controlled type 2 diabetes.

机构信息

Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France.

INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France.

出版信息

Acta Diabetol. 2019 Jul;56(7):749-754. doi: 10.1007/s00592-019-01340-7. Epub 2019 Apr 12.

DOI:10.1007/s00592-019-01340-7

PMID:30980187

Abstract

AIM

The impact of cholesteryl ester transfer protein (CETP) on atherosclerotic development in humans remains unclear. Plasma cholesteryl ester transfer was shown to be associated with carotid intima-media thickness in type 2 diabetic (T2D) patients with adequate metabolic control. Since glycation of CETP may influence cholesteryl ester transfer processes, it is important to determine if plasma cholesteryl ester transfer is still a determinant of carotid intima-media thickness (IMT) in patients with poorly controlled diabetes. The aim of the present study was to determine whether CETP activity influences carotid IMT in T2D patients with poor metabolic control.

METHODS

In 110 individuals with T2D, we measured CETP mass concentration with ELISA, CETP activity with a radioactivity method and carotid intima-media thickness with high-resolution real-time B-mode ultrasonography.

RESULTS

The mean HbA1C was 8.8 ± 1.7%. Carotid IMT did not correlate with CETP activity in the total population. In T2D patients with HbA1C < 8% (n = 33), mean HbA1C was 6.9% and the correlation between carotid IMT and CETP activity was not significant (p = 0.09). In a multivariable analysis that included the total population, carotid intima-media thickness was positively associated with diabetes duration (p = 0.02) but not with CETP activity or HbA1C.

CONCLUSIONS

We observed no correlation between carotid intima-media thickness, a marker of early atherosclerosis, and CETP activity in T2D patients with poor metabolic control. Disease duration, which reflects accumulated metabolic abnormalities, may have blunted the potential effect of CETP on atherosclerosis. Metabolic control appears essential to determine the pro- or anti-atherogenic influence of CETP in patients with T2D.

摘要

目的

胆固醇酯转移蛋白（CETP）对人类动脉粥样硬化发展的影响尚不清楚。研究表明，在代谢控制良好的 2 型糖尿病（T2D）患者中，血浆胆固醇酯转移与颈动脉内膜中层厚度有关。由于 CETP 的糖化可能会影响胆固醇酯转移过程，因此重要的是要确定在代谢控制不佳的糖尿病患者中，血浆胆固醇酯转移是否仍然是颈动脉内膜中层厚度（IMT）的决定因素。本研究旨在确定 CETP 活性是否会影响代谢控制不佳的 T2D 患者的颈动脉 IMT。

方法

在 110 名 T2D 患者中，我们使用 ELISA 测定 CETP 质量浓度，用放射性方法测定 CETP 活性，用高分辨率实时 B 型超声测量颈动脉内膜中层厚度。

结果

平均 HbA1C 为 8.8±1.7%。在总人群中，颈动脉 IMT 与 CETP 活性无相关性。在 HbA1C<8%（n=33）的 T2D 患者中，平均 HbA1C 为 6.9%，颈动脉 IMT 与 CETP 活性之间的相关性无统计学意义（p=0.09）。在包括总人群的多变量分析中，颈动脉内膜中层厚度与糖尿病病程呈正相关（p=0.02），但与 CETP 活性或 HbA1C 无关。