Sun Fang, Zhao Zhigang, Li Qiang, Zhou Xunmei, Li Yingsha, Zhang Hexuan, Yan Zhencheng, He Hongbo, Ke Zhigang, Gao Yu, Li Fan, Tong Weidong, Zhu Zhiming
Department of Hypertension and Endocrinology, Daping Hospital, Third Military Medical University, Center for Hypertension and Metabolic Diseases, Chongqing Institute of Hypertension, Chongqing 400042, People's Republic of China.
Department of General Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Apr 24;13:1349-1358. doi: 10.2147/DMSO.S250294. eCollection 2020.
High-sensitivity C-reactive protein (-CRP) has been regarded as a biomarker of low-degree inflammation in illness; however, whether CRP exerts its pathogenic effect on the cardiometabolic system remains unknown. Aside from the beneficial effects of metabolic surgery on cardiometabolic system, its impact on inflammation still worth examining. Thus, this study aims to investigate the effect of CRP on adipose and vascular cells, and their responses to metabolic surgery in obese diabetic patients.
The expression of CRP and RAS- and ERK-related factors in the adipocytes and VSMCs were measured. Obese patients with type 2 diabetes who underwent metabolic surgery were followed up for 2 years thereafter. Laboratory tests, which included serum -CRP levels and visceral fat thickness (VFT), were obtained before and after surgery.
CRP administration significantly and dose-dependently increased the intracellular-free calcium concentration ([Ca2+]i) in cultured adipocytes and in the VSMCs. CRP administration significantly increased ACE, Ang II, AT1R and p-ERK expressions, but reduced ACE2 expression in both the adipocytes and VSMCs. Clinical study showed that VFT was closely associated with serum -CRP. Furthermore, VFT and serum -CRP were found to be highly associated with blood pressure. Finally, metabolic surgery remarkably decreased blood pressure, visceral fat and serum -CRP levels.
CRP has a detrimental effect on cardiometabolic cells, aside from functioning merely as a biomarker. Serum -CRP levels are highly associated with hypertension and visceral obesity, which can be antagonized by metabolic surgery in obese diabetic patients.
高敏C反应蛋白（hs-CRP）被视为疾病中低度炎症的生物标志物；然而，CRP是否对心脏代谢系统产生致病作用仍不清楚。除了代谢手术对心脏代谢系统的有益作用外，其对炎症的影响仍值得研究。因此，本研究旨在探讨CRP对肥胖糖尿病患者脂肪和血管细胞的影响，以及它们对代谢手术的反应。
检测脂肪细胞和平滑肌细胞中CRP、RAS及ERK相关因子的表达。对接受代谢手术的肥胖2型糖尿病患者进行为期2年的随访。在手术前后进行实验室检查，包括血清hs-CRP水平和内脏脂肪厚度（VFT）。
给予CRP可显著且剂量依赖性地增加培养的脂肪细胞和平滑肌细胞内游离钙浓度（[Ca2+]i）。给予CRP可显著增加脂肪细胞和平滑肌细胞中ACE、Ang II、AT1R和p-ERK的表达，但降低ACE2的表达。临床研究表明，VFT与血清hs-CRP密切相关。此外，发现VFT和血清hs-CRP与血压高度相关。最后，代谢手术显著降低了血压、内脏脂肪和血清hs-CRP水平。
CRP除了仅作为生物标志物外，对心脏代谢细胞也有有害作用。血清hs-CRP水平与高血压和内脏肥胖高度相关，肥胖糖尿病患者可通过代谢手术对抗这种相关性。
