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1 型糖尿病患者伴发临床前颈动脉粥样硬化时,通过核磁共振对糖蛋白进行定量分析。

Quantification of glycoproteins by nuclear magnetic resonance associated with preclinical carotid atherosclerosis in patients with type 1 diabetes.

机构信息

Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain.

Diabetes Unit, Endocrinology and Nutrition Department, Institut d'Investigacions BiomèdiquesAugust Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.

出版信息

Nutr Metab Cardiovasc Dis. 2021 Jun 30;31(7):2099-2108. doi: 10.1016/j.numecd.2021.03.021. Epub 2021 Mar 31.

Abstract

BACKGROUND AND AIMS

Glycoproteins play a key role in inflammatory and cardiometabolic processes. Their implication in atherosclerosis in type 1 diabetes (T1D) is unknown. We assessed the relationships between classic inflammatory markers, glycoproteins measured by nuclear magnetic resonance (H-NMR), and preclinical atherosclerosis in these patients.

METHODS AND RESULTS

We selected patients with T1D, without cardiovascular disease (CVD), with: age ≥40 years, nephropathy (micro/macroalbuminuria), or ≥10 years of evolution with another risk factor. The presence of plaque (intima-media thickness >1.5 mm) was determined by ultrasonography. Concentrations of high-sensitive C-reactive protein (hsCRP), circulating leukocytes (classical inflammation markers) and H-NMR-glycoproteins (GlycA, GlycB, GlycF, and the height/width [H/W] ratios of GlycA and GlycB) were determined. We included 189 patients (58% male, age 47.0 [40.7-55.2] years). Thirty-five percent presented plaques (22%, ≥2 plaques). There was no association between hsCRP or leukocytes and atherosclerosis. However, in age- and sex-adjusted models, GlycA, GlycF, and the H/W ratios of GlycA and GlycB gradually increased with the number of plaques (0, 1, ≥2 plaques) only in patients without statins (p < 0.05), with no association in patients receiving this drug (p for interaction <0.05; in ≥2 plaques). Finally, in models adjusted for other classical and T1D-specific risk factors, GlycA and GlycB H/W ratios remained associated with carotid plaque (OR 1.39 [1.12-1.90] and OR 6.89 [1.85-25.62], respectively).

CONCLUSION

In T1D individuals without lipid-lowering treatment, H-NMR-glycoproteins were independently associated with the presence and amount of carotid atherosclerosis, unlike other classical inflammatory markers. Further studies are needed to ascertain their utility as CVD biomarkers.

摘要

背景与目的

糖蛋白在炎症和心血管代谢过程中起着关键作用。其在 1 型糖尿病(T1D)中的动脉粥样硬化中的作用尚不清楚。我们评估了这些患者中经典炎症标志物、通过核磁共振(H-NMR)测量的糖蛋白与临床前动脉粥样硬化之间的关系。

方法和结果

我们选择了年龄≥40 岁、患有肾病(微量/大量白蛋白尿)或有≥10 年病史且有其他危险因素的 T1D 患者,且无心血管疾病(CVD)。通过超声检查确定斑块(内膜-中层厚度>1.5mm)的存在。测定高敏 C 反应蛋白(hsCRP)、循环白细胞(经典炎症标志物)和 H-NMR-糖蛋白(GlycA、GlycB、GlycF 以及 GlycA 和 GlycB 的高度/宽度 [H/W] 比值)的浓度。我们共纳入了 189 名患者(58%为男性,年龄 47.0[40.7-55.2]岁)。35%的患者存在斑块(22%,≥2 个斑块)。hsCRP 或白细胞与动脉粥样硬化之间无相关性。然而,在年龄和性别调整模型中,仅在未接受他汀类药物治疗的患者中(p<0.05),随着斑块数量(0、1、≥2 个斑块)的增加,GlycA、GlycF 以及 GlycA 和 GlycB 的 H/W 比值逐渐增加,而在接受该药物治疗的患者中则无此关联(p 交互作用<0.05;在≥2 个斑块的情况下)。最后,在调整其他经典和 T1D 特异性危险因素的模型中,GlycA 和 GlycB 的 H/W 比值仍与颈动脉斑块相关(OR 1.39[1.12-1.90]和 OR 6.89[1.85-25.62])。

结论

在未接受降脂治疗的 T1D 个体中,与其他经典炎症标志物不同,H-NMR 糖蛋白与颈动脉粥样硬化的存在和数量独立相关。需要进一步的研究来确定它们作为 CVD 生物标志物的效用。

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