Aleem Mudassar, Maqsood Hamza, Younus Shifa, Zafar Ahmed F, Talpur Abdul Subhan, Shakeel Hassan
Internal Medicine, Nishtar Medical University, Multan, PAK.
Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.
Cureus. 2021 Sep 4;13(9):e17723. doi: 10.7759/cureus.17723. eCollection 2021 Sep.
Introduction Cardiovascular diseases are the leading cause of mortality in diabetic patients. Oxidative stress and mitochondrial dysfunction lead to diabetic cardiomyopathy (DCM) characterized by impaired cardiac structure and function. Hyperglycemia causes oxidative stress, which can lead to microvascular complications, macrovascular complications, and atherosclerosis. Peripheral tissues produce fibroblast growth factor 21 (FGF-21), which has anti-inflammatory properties, increases oxidation of fatty acids, and improves insulin sensitivity. Its increased levels are found in metabolic syndrome and type 2 diabetes mellitus and may also lead to coronary heart disease. Our study sought to measure the serum FGF-21 levels and their associations with lipid profile parameters and oxidative stress in patients with type 2 diabetes mellitus. Methodology One-hundred fifty (150) patients of both genders with type 2 diabetes mellitus were recruited along with 150 controls. Simple random sampling was done. After taking relevant history and physical examination, we drew venous blood samples of each patient and sent them to the institutional laboratory for analysis of fasting blood sugar (FBS) levels, glycated hemoglobin (HbA1C), lipid profile, and FGF-21 serum levels. Oxidative stress parameter malondialdehyde (MDA) was estimated and the total antioxidant status by ferric reducing antioxidant power assay (FRAP) was assessed. Patients were followed up after three months to record the glycemic index, and the values were recorded. We used SPSS Software 25.0 (SPSS, Inc., Chicago, USA) to analyze the data. For consideration of results to be statistically significant, a 𝑃 value of < 0.05 was selected. Results The levels of serum cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol were increased in diabetics compared to controls and were statistically significant (p<0.05). High-density lipoprotein (HDL) cholesterol was lower in diabetic patients as compared to the controls (p<0.05). There was a statistically significant increase in the level of MDA in diabetics compared to controls (p˂0.005). Serum levels of total antioxidant status (FRAP) were decreased in diabetics in comparison with controls (p˂0.005). Serum FGF-21 level was statistically increased in diabetics compared to controls (p˂0.005). FGF-21 and MDA are positively correlated and FGF-21 and FRAP are negatively correlated. Serum FGF-21 is positively correlated with total cholesterol, triglycerides, serum LDL cholesterol, and HDL cholesterol. Conclusion Our study concludes that there is a significant correlation between fibroblast growth factor 21, oxidative stress, and abnormal lipid profile in type 2 diabetic patients. FGF-21 could be the target of certain medications used to treat metabolic disorders and obesity.
引言
心血管疾病是糖尿病患者死亡的主要原因。氧化应激和线粒体功能障碍会导致糖尿病性心肌病（DCM），其特征是心脏结构和功能受损。高血糖会引发氧化应激，进而导致微血管并发症、大血管并发症和动脉粥样硬化。外周组织会产生具有抗炎特性、能增加脂肪酸氧化并改善胰岛素敏感性的成纤维细胞生长因子21（FGF - 21）。在代谢综合征和2型糖尿病患者中发现其水平升高，这也可能导致冠心病。我们的研究旨在测量2型糖尿病患者的血清FGF - 21水平及其与血脂参数和氧化应激的关联。
方法
招募了150名2型糖尿病患者（男女均有）以及150名对照者。采用简单随机抽样。在获取相关病史和进行体格检查后，采集每位患者的静脉血样本，并将其送至机构实验室分析空腹血糖（FBS）水平、糖化血红蛋白（HbA1C）、血脂谱和FGF - 21血清水平。估算氧化应激参数丙二醛（MDA），并通过铁还原抗氧化能力测定法（FRAP）评估总抗氧化状态。三个月后对患者进行随访以记录血糖指数，并记录相关数值。我们使用SPSS软件25.0（SPSS公司，美国芝加哥）分析数据。为使结果具有统计学意义，选取P值<0.05。
结果
与对照组相比，糖尿病患者的血清胆固醇、甘油三酯和低密度脂蛋白（LDL）胆固醇水平升高，且具有统计学意义（p<0.05）。与对照组相比，糖尿病患者的高密度脂蛋白（HDL）胆固醇水平较低（p<0.05）。与对照组相比，糖尿病患者的MDA水平有统计学意义的升高（p˂0.005）。与对照组相比，糖尿病患者的血清总抗氧化状态（FRAP）水平降低（p˂0.005）。与对照组相比，糖尿病患者的血清FGF - 21水平有统计学意义的升高（p˂0.005）。FGF - 21与MDA呈正相关，FGF - 21与FRAP呈负相关。血清FGF - 21与总胆固醇、甘油三酯、血清LDL胆固醇和HDL胆固醇呈正相关。
结论
我们的研究得出结论，2型糖尿病患者中成纤维细胞生长因子21、氧化应激和异常血脂谱之间存在显著相关性。FGF - 21可能是用于治疗代谢紊乱和肥胖的某些药物的靶点。
