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1型糖尿病合并早期微血管并发症青年患者中选定的炎症和氧化应激生物标志物与颈动脉内膜中层厚度(IMT)值之间的关系

The Relationship between Selected Inflammation and Oxidative Stress Biomarkers and Carotid Intima-Media Thickness (IMT) Value in Youth with Type 1 Diabetes Co-Existing with Early Microvascular Complications.

作者信息

Peczyńska Joanna, Klonowska Bożenna, Żelazowska-Rutkowska Beata, Polkowska Agnieszka, Noiszewska Klaudyna, Bossowski Artur, Głowińska-Olszewska Barbara

机构信息

Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, University Children's Clinical Hospital, Medical University of Bialystok, 15-274 Bialystok, Poland.

Department of Clinical Pediatrics, Faculty of Medical Sciences, Specialist Children's Hospital, University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland.

出版信息

J Clin Med. 2022 Aug 13;11(16):4732. doi: 10.3390/jcm11164732.

Abstract

Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in estimating the risk of cardiovascular disease (CVD) and explaining not fully understood pathogenesis of diabetic macroangiopathy. We aimed to analyze the relation between the intima-media thickness (IMT) of common carotid arteries and the occurrence of classical cardiovascular risk factors, together with the newly proposed biomarkers of CVD risk (high-sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO), adiponectin, N-terminal-pro B-type natriuretic peptide (NT-proBNP) and vitamin D) in youth with type 1 diabetes (T1D) recognized in screening tests to present early stages of microvascular complications (VC). The study group consisted of 50 adolescents and young adults with T1D, mean age 17.1 years (10-26 age range), including 20 patients with VC (+) and 30 VC (-). The control group (Control) consisted of 22 healthy volunteers, mean age 16.5 years (11-26 age range). In the VC (+) patients, we found a significantly higher concentration of HbA1c, lipid levels, hsCRP and NT-proBNP. BMI and blood pressure values were highest in the VC (+) group. Higher levels of MPO and lower levels of vitamin D were found in both diabetic groups vs. Control. IMT in VC (+) patients was significantly higher and correlated positively with HbA1c, hsCRP, NT-pro-BNP and negatively with vitamin D levels. In conclusion, youth with T1D and VC (+) present many abnormalities in the classical and new CVD biomarkers. hsCRP and MPO seem to be the most important markers for estimating the risk of macroangiopathy. NT-proBNP may present a possible marker of early myocardial injury in this population.

摘要

近年来已证实氧化应激和炎症生物标志物在评估心血管疾病(CVD)风险以及解释尚未完全明了的糖尿病大血管病变发病机制方面具有重要意义。我们旨在分析1型糖尿病(T1D)青年患者(在筛查试验中被认定处于微血管并发症(VC)早期阶段)的颈总动脉内膜中层厚度(IMT)与经典心血管危险因素的发生情况,以及新提出的CVD风险生物标志物(高敏C反应蛋白(hsCRP)、髓过氧化物酶(MPO)、脂联素、N末端B型利钠肽原(NT-proBNP)和维生素D)之间的关系。研究组由50名患有T1D的青少年和青年成年人组成,平均年龄17.1岁(年龄范围10 - 26岁),其中20例为VC(+)患者,30例为VC(-)患者。对照组(Control)由22名健康志愿者组成,平均年龄16.5岁(年龄范围11 - 26岁)。在VC(+)患者中,我们发现糖化血红蛋白(HbA1c)、血脂水平、hsCRP和NT-proBNP的浓度显著更高。VC(+)组的体重指数(BMI)和血压值最高。与对照组相比,两个糖尿病组的MPO水平更高,维生素D水平更低。VC(+)患者的IMT显著更高,且与HbA1c、hsCRP、NT-pro-BNP呈正相关,与维生素D水平呈负相关。总之,患有T1D且VC(+)的青年在经典和新型CVD生物标志物方面存在许多异常。hsCRP和MPO似乎是评估大血管病变风险的最重要标志物。NT-proBNP可能是该人群早期心肌损伤的一个潜在标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92be/9409989/9df0ae7ddbd5/jcm-11-04732-g001a.jpg

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