Hu Ting, Zhang Wen, Han Feifei, Zhao Rui, Liu Lihong, An Zhuoling
Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Front Cardiovasc Med. 2022 Jul 22;9:903412. doi: 10.3389/fcvm.2022.903412. eCollection 2022.
Type 2 diabetes mellitus (T2DM) is a well-established risk factor for cardiovascular disease, with at least 2-3 fold higher risk of cardiovascular diseases than non-diabetics. Free fatty acids (FFAs) are believed to play important roles in the occurrence of cardiovascular disease in people with T2DM. The aim of this study was to investigate the fingerprint of plasma FFAs and their correlations with the tradition risk factors of cardiovascular disease in T2DM patients complicated by coronary heart disease (CHD-T2DM). A total of 401 participants, including healthy control (HC, = 143), T2DM patients ( = 134), and CHD-T2DM patients ( = 126) were enrolled in this study. Plasma levels of 36 FFAs with carbon chain length ranged from 3 to 22 were quantified by using reverse phase ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS). Tradition risk factors of cardiovascular disease were tested in clinical laboratory, including homocysteine (HCY), creatine kinase (CK), high sensitivity C reactive protein (hsCRP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) and so on. Almost all the FFAs with different carbon chain length and unsaturation were significantly upregulated in the T2DM-CHD groups, compared to the HC and T2DM groups. Both n-3 and n-6 polyunsaturated fatty acids (PUFA) were also found to be significantly upregulated in T2DM-CHD group compared to the T2DM group. However, no significantly differences of the n-6/n-3 PUFA ratio, arachidonic acid/eicosapentaenoic acid (AA/EPA) ratio, and arachidonic acid/docosahexaenoic acid (AA/DHA) ratio were observed between T2DM-CHD and T2DM groups. Plasma FFA levels were found to be positively correlated with HCY, CK, hsCRP, NT-proBNP and other tradition risk factors of CHD. Multivariate logistic regression analysis indicated that a dozens of FFAs were the independent risk factors of CHD after adjustment for confounding factors and other risk factors. Excessively high plasma levels of FFAs were demonstrated to be independent risk factors for CHD in patients with T2DM, despite of the differences in chain length, unsaturation, and double bond position.
2型糖尿病(T2DM)是心血管疾病公认的危险因素,其患心血管疾病的风险至少是非糖尿病患者的2至3倍。游离脂肪酸(FFA)被认为在T2DM患者心血管疾病的发生中起重要作用。本研究旨在调查合并冠心病的T2DM患者(CHD-T2DM)血浆FFA的特征及其与心血管疾病传统危险因素的相关性。本研究共纳入401名参与者,包括健康对照(HC,n = 143)、T2DM患者(n = 134)和CHD-T2DM患者(n = 126)。使用反相超高效液相色谱-串联质谱法(UHPLC-MS/MS)对碳链长度为3至22的36种FFA的血浆水平进行定量。在临床实验室检测心血管疾病的传统危险因素,包括同型半胱氨酸(HCY)、肌酸激酶(CK)、高敏C反应蛋白(hsCRP)和N端脑钠肽前体(NT-proBNP)等。与HC组和T2DM组相比,几乎所有不同碳链长度和不饱和度的FFA在T2DM-CHD组中均显著上调。与T2DM组相比,T2DM-CHD组中n-3和n-6多不饱和脂肪酸(PUFA)也显著上调。然而,T2DM-CHD组和T2DM组之间在n-6/n-3 PUFA比值、花生四烯酸/二十碳五烯酸(AA/EPA)比值和花生四烯酸/二十二碳六烯酸(AA/DHA)比值方面未观察到显著差异。发现血浆FFA水平与HCY、CK、hsCRP、NT-proBNP和其他冠心病传统危险因素呈正相关。多因素逻辑回归分析表明,在调整混杂因素和其他危险因素后,多种FFA是冠心病的独立危险因素。尽管在碳链长度、不饱和度和双键位置存在差异,但过高的血浆FFA水平被证明是T2DM患者冠心病的独立危险因素。