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2型糖尿病中促炎标志物、白细胞与内皮细胞相互作用和颈动脉内膜中层厚度之间的关联:血糖控制的作用

Association between Proinflammatory Markers, Leukocyte-Endothelium Interactions, and Carotid Intima-Media Thickness in Type 2 Diabetes: Role of Glycemic Control.

作者信息

de Marañón Aranzazu Martinez, Iannantuoni Francesca, Abad-Jiménez Zaida, Canet Francisco, Díaz-Pozo Pedro, López-Domènech Sandra, Roldán-Torres Ildefonso, Morillas Carlos, Rocha Milagros, Víctor Víctor M

机构信息

Service of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain.

Service of Cardiology, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain.

出版信息

J Clin Med. 2020 Aug 5;9(8):2522. doi: 10.3390/jcm9082522.

Abstract

Glycated hemoglobin monitorization could be a tool for maintaining type 2 diabetes (T2D) under control and delaying the appearance of cardiovascular events. This cross-sectional study was designed to assess the role of glycemic control in modulating early-stage markers of cardiovascular complications. One hundred and eight healthy controls and 161 type 2 diabetic patients were recruited and distributed according to their glycemic control, setting the threshold at 6.5% (good control). Biochemical and anthropometrical parameters were registered during the initial visit, and peripheral blood was extracted to obtain polymorphonuclear cells and analyze inflammatory markers, adhesion molecules, leukocyte-endothelium interactions, and carotid intima-media thickness. Correlations between these parameters were explored. We found that inflammatory markers and adhesion molecules were augmented in type 2 diabetic subjects with poor glycemic control. Polymorphonuclear leukocytes interacted more with the endothelium in the diabetic population, and even more significantly in the poorly controlled subjects. In parallel, carotid intima-media thickness was also increased in the diabetic population, and the difference was greater among poorly controlled subjects. Finally, correlation measurement revealed that carotid intima-media thickness was related to glycemic control and lipid metabolism in diabetic patients. Our results suggest that glycemic control delays the onset of cardiovascular comorbidities in diabetic subjects.

摘要

糖化血红蛋白监测可能是控制2型糖尿病(T2D)并延缓心血管事件出现的一种手段。这项横断面研究旨在评估血糖控制在调节心血管并发症早期标志物方面的作用。招募了108名健康对照者和161名2型糖尿病患者,并根据他们的血糖控制情况进行分组,将阈值设定为6.5%(良好控制)。在初次就诊时记录生化和人体测量参数,并抽取外周血以获取多形核细胞并分析炎症标志物、黏附分子、白细胞与内皮细胞的相互作用以及颈动脉内膜中层厚度。探索了这些参数之间的相关性。我们发现,血糖控制不佳的2型糖尿病患者的炎症标志物和黏附分子增加。在糖尿病患者中,多形核白细胞与内皮细胞的相互作用更多,在控制不佳的患者中更为显著。同时,糖尿病患者的颈动脉内膜中层厚度也增加,在控制不佳的患者中差异更大。最后,相关性测量显示,糖尿病患者的颈动脉内膜中层厚度与血糖控制和脂质代谢有关。我们的结果表明,血糖控制可延缓糖尿病患者心血管合并症的发生。

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