Ljuca Kenana, Aščerić Mensura, Batić-Mujanović Olivera, Loga-Zec Svjetlana, Ljuca Nadina, Bećirović Emir, Bejić Samir, Jovanović Predrag, Bećirović Minela
Department of Gynecology and Obstetrics, University Clinical Center Ljubljana, Ljubljana, Slovenia; Health Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina; School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.
Department of Pharmacology, School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.
Biomol Biomed. 2025 May 8;25(7):1522-1527. doi: 10.17305/bb.2024.11512.
The aim of the current research was to investigate the association between plasma endocan levels and metabolic control parameters, as well as to evaluate its predictive value for clinical complications in patients with type 2 diabetes mellitus (DMT2). A total of 100 DMT2 patients participated in this prospective observational study. Plasma endocan levels were significantly elevated in DMT2 patients with HbA1c > 7% (1.38 ± 0.33 vs 0.68 ± 0.23 ng/mL; P < 0.0001), compared to patients with HbA1c ≤ 7%. Patients with plasma endocan concentrations >1.10 ng/mL (median value of 1.10 ng/mL) demonstrated significantly higher levels of metabolic parameters: body mass index (BMI), HbA1c (%), fasting glucose level, LDL cholesterol, total cholesterol, triglycerides, along with significantly lower HDL cholesterol levels. Furthermore, patients with plasma endocan levels >1.10 ng/mL were found to have an increased risk for the following complications: retinopathy (relative risk [RR]: 2.7500; 95% confidence interval [CI]: 1.2150-6.2244; P = 0.0152, nephropathy (RR: 2.0952; 95% CI: 1.2294-3.5710; P = 0.0065), neuropathy (RR: 1.9945; 95% CI: 1.2025-3.3081; P = 0.0075), angina pectoris (RR: 2.4881; 95% CI: 1.0865-5.6979; P = 0.0311, hypertension (RR: 1.1372; 95% CI: 1.0060-1.2856; P = 0.0398), cardiomyopathy (RR: 2.6190; 95% CI: 1.1507-5.9612; P = 0.0218), myocardial infarction (RR: 9.4286; 95% CI: 1.2742-69.7697; P = 0.0280) and stroke (RR: 4.4638; 95% CI: 1.3765-14.4758; P = 0.0127). Correlation analysis revealed that plasma endocan levels were positively correlated with HbA1c (%) (r = 0.856, P < 0.0001), fasting glucose level (r = 0.631, P < 0.0001), LDL (r = 0.347, P = 0.0004), cholesterol (r = 0.282, P = 0.0045), and triglycerides (r = 0.366, P = 0.0002). Conversely, plasma endocan levels were negatively correlated with HDL cholesterol (r = -0.429, P < 0.0001). In conclusion, higher plasma endocan levels were strongly associated with poor metabolic control in DMT2 patients and exhibited significant predictive value for both microvascular and macrovascular complications.
当前研究的目的是调查血浆内脂素水平与代谢控制参数之间的关联,并评估其对2型糖尿病(DMT2)患者临床并发症的预测价值。共有100例DMT2患者参与了这项前瞻性观察研究。与糖化血红蛋白(HbA1c)≤7%的患者相比,HbA1c>7%的DMT2患者血浆内脂素水平显著升高(1.38±0.33 vs 0.68±0.23 ng/mL;P<0.0001)。血浆内脂素浓度>1.10 ng/mL(中位数为1.10 ng/mL)的患者代谢参数水平显著更高:体重指数(BMI)、HbA1c(%)、空腹血糖水平、低密度脂蛋白胆固醇、总胆固醇、甘油三酯,同时高密度脂蛋白胆固醇水平显著更低。此外,发现血浆内脂素水平>1.10 ng/mL的患者发生以下并发症的风险增加:视网膜病变(相对风险[RR]:2.7500;95%置信区间[CI]:1.2150 - 6.2244;P = 0.0152)、肾病(RR:2.0952;95% CI:1.2294 - 3.5710;P = 0.0065)、神经病变(RR:1.9945;95% CI:1.2025 - 3.3081;P = 0.0075)、心绞痛(RR:2.4881;95% CI:1.0865 - 5.6979;P = 0.0311)、高血压(RR:1.1372;95% CI:1.0060 - 1.2856;P = 0.0398)、心肌病(RR:2.6190;95% CI:1.1507 - 5.9612;P = 0.0218)、心肌梗死(RR:9.4286;95% CI:1.2742 - 69.7697;P = 0.0280)和中风(RR:4.4638;95% CI:1.3765 - 14.4758;P = 0.0127)。相关性分析显示,血浆内脂素水平与HbA1c(%)(r = 0.856,P<0.0001)、空腹血糖水平(r = 0.631,P<0.0001)、低密度脂蛋白(r = 0.347,P = 0.0004)、胆固醇(r = 0.282,P = 0.0045)和甘油三酯(r = 0.366,P = 0.0002)呈正相关。相反,血浆内脂素水平与高密度脂蛋白胆固醇呈负相关(r = -0.429,P<0.0001)。总之,较高的血浆内脂素水平与DMT2患者代谢控制不佳密切相关,并且对微血管和大血管并发症均具有显著的预测价值。