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