高血压糖尿病患者脂质指标、IV型胶原代谢与微血管并发症发生的关系

Relationship between Lipid Indices, Type IV Collagen Turnover and the Development of Microvascular Complications in Diabetic Patients with Arterial Hypertension.

作者信息

Nikolov Asparuh, Tzekova Maria, Blazhev Alexander

机构信息

Institute for Scientific Research, Medical University, Pleven, Bulgaria.

Department of Propedeutics of Internal Diseases, Medical University, Pleven, Bulgaria.

出版信息

Folia Med (Plovdiv). 2019 Jun 1;61(2):231-239. doi: 10.2478/folmed-2018-0072.

DOI:10.2478/folmed-2018-0072

PMID:31301656

Abstract

BACKGROUND AND AIMS

An important factor in the development of vascular wall lesions is the degradation of the major protein of connective tissue - type IV collagen. Type IV collagen peptides (CIVDP) derived from this degradation are present in the circulation and are a stimulus for production of anti-collagen type IV antibodies (ACIVAbs) IgM, IgG and IgA. The aim of this study was to find a possible association between ACIVAbs, lipid indices and the development of microvascular complications.

MATERIALS AND METHODS

Sera of 93 patients (mean age 61.4±11.3 yrs, diabetes duration 9.88±3.12 yrs; hypertension duration 9.28±4.98) with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) were investigated. ACIVAbs was determined using ELISA and then compared to serum ACIVAbs in 42 age- and sex-matched controls. Diabetics were divided into two groups according to presence (group 1, n=67) or absence (group 2, n=26) of microangiopathy. Lipid profile and lipid indices (log TG/HDL, LDL/HDL, TC/HDL and TG/HDL) were examined too.

RESULTS

Patients with T2DM and AH showed statistically significant higher levels of serum ACIVAbs IgG than healthy controls [0.298 (0.237÷0.381) vs 0.210 (0.149÷0.262), KW=14.01, p<0.0001]. Group 1 had statistically significant higher levels of ACIVAbs IgG than patients without microangiopathy [0.323 (0.243÷0.391) vs 0.241 (0.207÷0.291), KW=7.66, p=0.006] and healthy controls [0.210 (0.149÷0.262), KW=17.52, p<0.0001). ACIVAbs IgG showed correlation with duration of diabetes (r=0.49, p=0.01), retinopathy (r=-0.20, p=0.04) and BMI (r=-0.24, p=0.05), HbA1c (r=0.21, p=0.04), SBP (r=0.16, p=0.05). ACIVAbs IgG correlated with log TG/HDL (r=0.21, p=0.01), LDL/HDL (r=0.19, p=0.02) TC/HDL (r=0.16, p=0.05) and with TG/HDL (r=0.15, p=0.05).

CONCLUSION

Our study shows relationship between elevation of ACIVAbs IgG, high lipid indices and development of microvascular complications in patients with type 2 diabetes mellitus and arterial hypertension.

摘要

背景与目的

血管壁病变发展的一个重要因素是结缔组织主要蛋白质——IV型胶原蛋白的降解。源自这种降解的IV型胶原蛋白肽（CIVDP）存在于循环系统中，是产生抗IV型胶原蛋白抗体（ACIVAbs）IgM、IgG和IgA的刺激因素。本研究的目的是寻找ACIVAbs、血脂指标与微血管并发症发展之间可能存在的关联。

材料与方法

对93例2型糖尿病（T2DM）合并动脉高血压（AH）患者（平均年龄61.4±11.3岁，糖尿病病程9.88±3.12年；高血压病程9.28±4.98年）的血清进行了研究。采用酶联免疫吸附测定法（ELISA）测定ACIVAbs，然后与42名年龄和性别匹配的对照组的血清ACIVAbs进行比较。根据是否存在微血管病变（1组，n = 67；2组，n = 26）将糖尿病患者分为两组。同时检测了血脂谱和血脂指标（log TG/HDL、LDL/HDL、TC/HDL和TG/HDL）。

结果

T2DM合并AH患者的血清ACIVAbs IgG水平在统计学上显著高于健康对照组[0.298（0.237÷0.381）对0.210（0.149÷0.262），KW = 14.01，p < 0.0001]。1组的ACIVAbs IgG水平在统计学上显著高于无微血管病变的患者[0.323（0.243÷0.391）对0.241（0.207÷0.291），KW = 7.66，p = 0.006]和健康对照组[0.210（0.149÷0.262），KW = 17.52，p < 0.0001]。ACIVAbs IgG与糖尿病病程（r = 0.49，p = 0.01）、视网膜病变（r = -0.20，p = 0.04）、体重指数（r = -0.24，p = 0.05）、糖化血红蛋白（r = 0.21，p = 0.04）、收缩压（r = 0.16，p = 0.05）相关。ACIVAbs IgG与log TG/HDL（r = 0.21，p = 0.01）、LDL/HDL（r = 0.19，p = 0.02）、TC/HDL（r = 0.16，p = 0.05）以及TG/HDL（r = 0.15，p = 0.05）相关。