Association between serum adipocytokine levels and microangiopathies in patients with type 2 diabetes mellitus

Aims/Introduction

It is thought that adipocytokines contribute to the increased risk of vascular complications in type 2 diabetes. However, there is still limited information on the relationship between microangiopathies and adipocytokines, such as adiponectin, leptin and tumor necrosis factor‐α (TNF‐α) in patients with type 2 diabetes.

Materials and Methods

The present study examined the relationship between fasting serum adiponectin, leptin, and TNF‐α levels and microangiopathies in Korean type 2 diabetes. A total of 153 patients were recruited and evaluated for diabetic nephropathy, retinopathy and neuropathy. Serum adiponectin, TNF‐α and leptin levels were measured.

Results

Serum adiponectin levels were significantly lower in patients with nephropathy than in those without nephropathy (P = 0.017), and were significantly higher in patients with retinopathy or neuropathy than those without retinopathy or neuropathy (P = 0.01 and P = 0.002, respectively). The mean levels of leptin were significantly higher in patients with neuropathy than in those without neuropathy (P = 0.002). The mean levels of TNF‐α were not significantly different according to any of the three microangiopathies. Multivariate logistic regression analysis showed that the odds ratio for the presence of neuropathy in the highest tertile of adiponectin was 4.3 (95% confidence interval 1.59–11.62), as compared with the patients in the lowest tertile of adiponectin level.

Conclusions

Levels of adipocytokines were significantly different according to the presence of each microangiopathy. In particular, higher serum adiponectin was independently associated with increased odds for the presence of neuropathy. Future prospective studies with larger numbers of patients are required to establish a direct relationship between plasma adipocytokine concentrations and the development or severity of diabetic microangiopathies.     

超重和肥胖人群血清脂联素水平与2型糖尿病的关系

目的研究血清脂联素水平与超重、肥胖及与血糖（PG）的关系。方法对深圳地区21～60岁人群共29799人进行BMI，腰围（WC），腰臀围比（WHR）及血糖检测，按BMI高低分成三大组：正常非肥胖（NC）组（BMI≤24）男10267人、女14268人；超重（OW）组（24〈BMI〈28）男2952人、女1800人；和肥胖（Ob）组（BMI≥28）男245人、女267人。Ob组按血糖水平又分为单纯肥胖（S-Ob）组（男190人，女216人）和2型糖尿病肥胖（T2DM-Ob）组（男55人，女51人）。调查三大组人群T2DM的患病率，分析BMI、WC、WHR与T2DM的关系，并测定各组人群的血清脂联素水平。结果T2DM的患病率在NC组男性和女性分别为32‰和35‰；在OW组的男性和女性分别为126‰和106‰；在肥胖组的男性和女性分别为225‰和191‰。T2DM的患病率在男性WC〉85cm者显著高于WC≤85cm者，在女性，WC〉80cm者显示高于WC≤80cm者（P均〈0．01）。血清脂联素浓度在Ow组、Ob组及T2DM—Ob组均显著低于NC组（P=0．000）。在T2DM—Ob患者中，脂联素浓度与BMI、WC、WHR、PG呈显著负相关。结论脂联素浓度变化可能与肥胖及糖尿病密切相关。保持BMI和WC在正常范围，是预防糖尿病发生的有效措施之一。     

血清脂联素和抵抗素与2型糖尿病及其大血管病变相关

测定2型糖尿病患者血清脂联素和抵抗素水平,发现2型糖尿病组血清脂联素浓度(2.51±1.42)mg/L低于正常对照组(5.26±0.78)mg/L,2型糖尿病大血管病变组为(1.38±0.77)mg/L又低于非大血管病变组(3.66±0.91)mg/L,差异均有统计学意义(均P＜0.01).2型糖尿病组血清抵抗素浓度(7.07±1.11)μg/L高于正常对照组(6.09±0.47)μg/L,2型糖尿病大血管病变组为(7.96±0.65)μg/L又高于非大血管病变组(6.10±0.43)μg/L,差异均有统计学意义(均P＜0.01).     

老年糖尿病患者血清脂联素与炎症因子的相关性研究

目的检测老年糖尿病患者血清脂联素与炎症因子水平,并探讨二者的相关性。方法测定老年健康人(对照组)、老年2型糖尿病无大血管并发症患者(无血管病变组)及2型糖尿病伴大血管并发症患者(血管病变组)的血清脂联素与炎症因子C反应蛋白、肿瘤坏死因子(TNF-α)水平。结果血清脂联素水平,对照组、无血管病变组及血管病变组分别为(10．67±3．26)mg/L、(6．43±2．64)mg/L和(4．31±2．17)mg/L,组间比较差异有统计学意义(均为P＜0．01);3组血浆C反应蛋白水平分别为(1．64±0．37)mg/L、(4．86±1．82)mg/L和(6．62±1．91)mg/L,TNF-α分别为(5．83±1．37)pg/L、(8．94±3．28)pg/L和(15．31±3．65)pg/L,依次逐渐升高,组间比较差异有统计学意义(均为P＜0．01)。无血管病变组和血管病变组脂联素与C反应蛋白、TNF-α、腰围、体质指数、腰臀比值及空腹血糖、餐后2 h血糖、糖化血红蛋白、三酰甘油均呈显著负相关。多元逐步回归分析显示,脂联素与C反应蛋白(r~2=0．18)、TNF-α(r~2=0．25)、腰臀比(r~2=0．21)及糖化血红蛋白(r~2= 0．19)具有相关性(均为P＜0．05)。结论脂联素可能是老年人糖尿病发生、发展及糖尿病大血管病变形成中炎症反应的保护因素。     

Association of adiponectin with dietary factors and cardiovascular risk factors in type 2 diabetes mellitus patients

Background and aimAdiponectin, is an adipose tissue-specific adipokine, that circulates in human plasma at high levels, although lower levels are noted with insulin resistance and atherosclerosis. We investigated the relationship of adiponectin concentrations with dietary factors and some of the cardiovascular risk factors in patients with T2DM.Methods and resultsTotally 107 patients with T2DM were recruited from the out patients clinic of Shariati Hospital, Tehran, Iran. Patients were evaluated for laboratory and anthropometric measurements including serum adiponectin, fasting insulin, FPG, OGTT, HbA1c, HOMA-IR, hsCRP, weight, height, BMI and WHR. Nutrients intakes were obtained via 24-h recall from each patient in three successive days. Nutrients and data analysis were done using FPII and SPSS version 13 softwares. The mean of log 10-transformed serum adiponectin concentration was 0.79 ± 0.27 μg/ml. The univariate linear regression analysis could not show any significant relation between the log of serum adiponectin and dietary factors. In multivariate linear regression after multiple adjustment, the log of serum adiponectin was independently associated with WHR (P = 0.02, t = ?2.33), HDL-C (P = 0.050, t = 2.03) and markedly but not significantly with age of patients (P = 0.058, t = 1.92).ConclusionsOur findings showed that WHR, one of the important cardiovascular risk factors, can modulate independently adiponectin levels of T2DM patients in inverse manner. Also, the age of patients and HDL-C levels have marked positive effect on circulating levels of this adipocytokine. Thus, adiponectin might be a useful biomarker to prevent developing CVD in type 2 diabetes.     

Association between serum remnant cholesterol and diabetic kidney disease in elderly patients with type 2 diabetes mellitus

<正>Objective To investigate the correlation between serum remnant cholesterol(RC) and diabetic kidney disease(DKD) in elderly patients with type 2 diabetes mellitus(T2DM).Methods The elderly patients with T2DM who were hospitalized in the Department of Geriatrics of the Second Xiangya Hospital of Central South University from January 2021 to March 2022 were selected and divided into simple diabetes group(410 cases)and DKD group(433 cases).     

Association of serum TRAIL levels with atherosclerosis in patients with type 2 diabetes mellitus

Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) was originally isolated as an inducer of apoptosis. Recent cross-sectional and prospective studies suggest an inverse association of serum TRAIL levels with the severity of coronary artery disease (CAD) and with an adverse outcome in patients with CAD or heart failure. However, it is unknown whether TRAIL can inversely reflect the progression of atherosclerosis from its early stage. We therefore examined the association between TRAIL measured by ELISA and intima-media thickness (IMT) in carotid and femoral arteries evaluated by ultrasonography as a surrogate marker of atherosclerosis in 416 type 2 diabetic patients without any symptoms of CAD and heart failure. Concurrently, the existence of calcified plaque (CP) was examined. There was no significant association between TRAIL and carotid IMT (ρ = −0.096, p = 0.052) or femoral IMT (ρ = −0.025, p = 0.610), although TRAIL was associated with carotid IMT in a subset of patients with macrovascular diseases (ρ = −0.174, p = 0.034). No difference in TRAIL levels was found between two groups with or without CP. TRAIL may not be a good candidate as a biomarker to evaluate early-stage atherosclerotic lesions.     

血清CTRP5、脂联素与颈动脉粥样硬化的关系

目的:探讨2型糖尿病(T2DM)血清C1q/肿瘤坏死因子相关蛋白5(CTRP5)、脂联素(APN)的水平与颈动脉粥样硬化(CAS)的关系。方法:采用病例对照研究,纳入2019年8月至2019年11月就诊于山西医科大学第二医院的患者共125例,其中健康对照组45例,T2DM无CAS患者(T2DM组)40例及T2DM合并C...     

2型糖尿病患者血瘦素水平与高血压的相关性研究

选择122例2型糖尿病患者,分为合并高血压组和血压正常组,各组又分别分为肥胖和非肥胖亚组.测定其体重指数(BMI)、空腹血糖(FBG)和胰岛素、糖化血红蛋白(HbA1c)及血清瘦素水平,并作相关性分析.结果显示,2型糖尿病患者高血压组与非高血压组间血清瘦素水平无差异(P＞0.05);血清瘦素水平与BMI、空腹胰岛素呈正相关关系(P＜0.01),与血压无明显相关性(P＞0.05);但在合并高血压组,血清瘦素水平与HbA1c呈负相关关系(P＜0.05).提示2型糖尿病患者的血清瘦素水平与血压无明显相关性,但合并高血压患者长时间血糖控制不良可能会导致血清瘦素水平的下降.     

Association between serum estradiol concentrations and carotid atherosclerosis in men with type 2 diabetes mellitus

The aim of this study was to evaluate relationships between serum estradiol concentration and carotid atherosclerosis in addition to major cardiovascular risk factors in men with type 2 diabetes mellitus because previous reports concerning the role of estrogen on atherosclerosis in men are conflicting. Serum estradiol concentrations were measured in 305 consecutive men with type 2 diabetes mellitus. Relationships were evaluated between serum estradiol concentration and carotid atherosclerosis, as determined by ultrasonographically evaluated intima-media thickness (IMT) and plaque score, in a subgroup of 144 diabetic patients, as well as major cardiovascular risk factors, including age, blood pressure, and lipid concentrations. An inverse correlation was found between serum estradiol concentration and IMT (r = -0.174, P = .0369), but no correlation was found between serum estradiol concentration and plaque score. Patients with serum estradiol concentrations in the lowest tertile displayed significantly higher IMT compared with patients in the highest tertile (P = .0083). Serum estradiol concentration was not a determinant of IMT (beta = -.121, P = .1396) in the multiple regression analysis. An inverse correlation was found between serum estradiol concentration and triglyceride concentration (r = -0.136, P = .0186). In conclusion, serum estradiol concentration is inversely associated with carotid atherosclerosis as determined by ultrasonographically evaluated IMT in men with type 2 diabetes mellitus.     

Mean platelet volume in patients with type 2 diabetes mellitus

AIM OF THE STUDY: To evaluate mean platelet volume (MPV) in type 2 diabetic versus non-diabetic patients, as well as to investigate the associations between MPV and diabetic complications. MATERIALS AND METHODS: This study included 416 patients divided into two groups. Group A comprised 265 type 2 diabetic patients (131 men) with a mean age of 67.4 +/- 9.5 years and a mean diabetes duration of 14.5 +/- 5.7 years. Group B comprised 151 non-diabetic patients (74 men) with a mean age of 68.6 +/- 9.1 years. MPV (blood samples anticoagulated with sodium citrate) was measured in two blood cell counters (Sysmex SF 3000 and Cell-Dyn 3700). RESULTS: MPV was significantly higher (P = 0.01) in group A (14.2 +/- 2.2 fl) than in group B (7.1 +/- 1.2 fl). In group A MPV was significantly higher (P = 0.043) in patients with retinopathy (15.8 +/- 1.3 fl) than in patients without retinopathy (10.9 +/- 1.1 fl) and also significantly higher (P = 0.044) in patients with microalbuminuria (15.6 +/- 1.2 fl) than in patients without microalbuminuria (10.1 +/- 1.2 fl). No association, however, was found in group A between MPV and age, gender, duration of diabetes, insulin dependency, BMI, HbA1c, coronary artery disease or dyslipidaemia. CONCLUSIONS: MPV is higher in type 2 diabetic patients than in non-diabetic patients. Among type 2 diabetic patients MPV is higher in those who have microvascular complications (retinopathy or microalbuminuria).     

脂联素与2型糖尿病乳腺癌发生的相关性及其机制研究

目的:探讨脂联素与2型糖尿病（T2DM）患者乳腺癌发生的相关性及其可能机制。方法:选取2016年1至6月于安徽医科大学第一附属医院甲状腺与乳腺外科住院的乳腺癌患者50例作为研究对象。按照是否合并T2DM将纳入患者分为合并T2DM的乳腺癌组（20例）以及单纯乳腺癌组（30例）。检测空腹血糖和胰岛素、血脂、总脂联素、高分子...     

老年2型糖尿病血清脂联素水平变化与颈动脉内膜-中层厚度的关系

目的 探讨老年2型糖尿病（T2DM）患者血清脂联素（APN）水平与颈动脉内膜，中层厚度（IMT）的关系。方法 将55例老年T2DM患者根据颈动脉IMT分成轻度组（IMT〈1．0mm，34例）及重度组（IMT≥1．0mm，21例），采用酶联免疫法测定血清APN值，并与健康体检者进行比较。结果 他DM组血清APN水平显著低于正常对照组，而且降低程度与颈动脉IMT程度相关，重度IMT组APN水平降低尤为明显。相关分析发现，APN与IMT呈显著负相关。结论 APN水平降低参与老年T2DM颈动脉狭窄的发生和发展过程，与颈动脉粥样硬化性狭窄关系密切。     

Mean platelet volume in patients with type 2 diabetes mellitus

Aim of the study: To evaluate mean platelet volume (MPV) in type 2 diabetic versus non-diabetic patients, as well as to investigate the associations between MPV and diabetic complications.

Materials and methods: This study included 416 patients divided into two groups. Group A comprised 265 type 2 diabetic patients (131 men) with a mean age of 67.4?±?9.5 years and a mean diabetes duration of 14.5?±?5.7 years. Group B comprised 151 non-diabetic patients (74 men) with a mean age of 68.6?±?9.1 years. MPV (blood samples anticoagulated with sodium citrate) was measured in two blood cell counters (Sysmex SF 3000 and Cell-Dyn 3700).

Results: MPV was significantly higher (P?=?0.01) in group A (14.2?±?2.2?fl) than in group B (7.1?±?1.2?fl). In group A MPV was significantly higher (P?=?0.043) in patients with retinopathy (15.8?±?1.3?fl) than in patients without retinopathy (10.9?±?1.1 fl) and also significantly higher (P?=?0.044) in patients with microalbuminuria (15.6?±?1.2?fl) than in patients without microalbuminuria (10.1?±?1.2?fl). No association, however, was found in group A between MPV and age, gender, duration of diabetes, insulin dependency, BMI, HbA_1c, coronary artery disease or dyslipidaemia.

Conclusions: MPV is higher in type 2 diabetic patients than in non-diabetic patients. Among type 2 diabetic patients MPV is higher in those who have microvascular complications (retinopathy or microalbuminuria).     

2型糖尿病患者趾臂指数(TBI)与动脉粥样硬化的相关性研究

目的 研究踝臂指数(ABI)正常的2型糖尿病患者趾臂指数(TBI)与动脉粥样硬化的相关性.方法 瑞金医院内分泌代谢病科门诊收集的945例ABI正常(0.9≤ABI＜1.3)患者,根据TBI分为正常组(TBI≥0.6,n=893)和降低组(TBI＜0.6,n=52).分析TBI与颈动脉内中膜厚度(IMT)的相关性,以及TBI降低与动脉粥样硬化之间的关系.结果 TBI降低组的年龄及HbA1C明显高于TBI正常组.TBI与IMT显著负相关,回归系数β=-0.217(P＜0.01).按照TBI＜0.6,0.6≤TBI＜0.8,0.8≤TBI＜1.0,TBI≥1.0分为4组,以TBI等级变量为自变量,是否发生动脉粥样硬化为因变量,进行多元logistic回归分析,TBI降低是动脉粥样硬化的独立危险因素(OR=1.30,95% CI 1.01～1.69,P＜0.05).结论 在2型糖尿病中,TBI的降低是动脉粥样硬化的独立危险因素,有必要在糖尿病患者中早期检测TBI,以便检测到ABI不能发现的动脉硬化及狭窄,及早进行干预,降低糖尿病动脉粥样硬化的风险.     

2型糖尿病脂联素水平与心脑血管病变关系的研究

目的探讨血清脂联素与2型糖尿病(T2DM)心脑血管病变的关系。方法选健康体检者(A组)35例,单纯糖尿病(B组)42例,糖尿病合并心脑血管病变(C组)38例,测定各组血清脂联素水平及其血糖、血脂、空腹胰岛素等指标,计算胰岛素抵抗数;测定反映心脑血管粥样硬化的早期指标-颈动脉内膜中层厚度(CIMT),进行统计学分析。结果 (1)B组脂联素水平低于A组(P0.01),C组脂联素水平低于A组及B组(P0.01),B、C组患者均比A组存在明显的代谢紊乱和胰岛素抵抗。(2)脂联素与CIMT的变化呈显著负相关(P0.01)。(3)多元线性逐步回归分析提示:脂联索及高密度脂蛋白胆固醇降低、甘油三酯增高是T2MD患者CIMT增厚的危险因素。结论血清脂联素水平降低是2型糖尿病患者动脉粥样硬化的独立危险因子之一,能够改善胰岛素抵抗、调节血糖血脂、降低血压、延缓T2DM的大血管动脉粥样硬化等作用,对糖尿病心脑血管病变起到保护作用。     

2型糖尿病血清脂联素与心血管相关标志物相关性的研究

目的检测老年糖尿病(DM)患者血清脂联素(APN)与3个心血管相关标志物水平并探讨二者之间的相关关系。方法将70例老年受试者分为3组:正常对照组、老年DM未合并大血管病变组(DM1)和老年DM合并大血管病变组(DM2),检测血清APN与心血管相关标志物-血浆C反应蛋白(c-reactive protein,CRP)、Ⅰ型血浆纤溶酶原活化抑制剂(plasminogen activator inhibitor type-1,PAI-1)和血清基质金属蛋白酶-9(matrx metalloproteinase-9,MMP-9)的水平变化。结果从正常对照组、DM1到DM2组血清APN水平依次下降,各组间差别均具有显著意义(均P<0.01)从正常对照组、DM1到DM2组,CRP、PAI-1、MMP-9的水平逐渐升高,CRP、PAI-1升高在各组间均具有显著性(均P<0.05),MMP-9在DM2组开始出现显著升高(P<0.01),DM1组较正常对照组升高没有显著意义。APN水平与CRP、PAI-1、腰围、BMI、WHR及FBG、2h PBG、HbA1C、TG呈显著负相关。多元逐步回归分析显示APN与CRP(r2=0.18)、PAI-1(r2=0.16)、WHR(r2=0.21)及HbA1C(r2=0.19)具有高度的相关性(均P<0.05)结论APN可能是老年DM动脉粥样硬化发生发展中的保护因素。     

Association between serum testosterone concentration and collagen degradation fragments in men with type 2 diabetes mellitus

The aim of the present study was to evaluate relationships between serum endogenous androgens and urinary concentration of cross-linked N-telopeptides of type I collagen (NTx), a bone resorption marker, in men with type 2 diabetes mellitus because low androgen concentrations are associated with both osteoporosis and cardiovascular disease. Relationships between serum free testosterone and urinary NTx concentrations were investigated in 246 consecutive men with type 2 diabetes mellitus. In addition, relationships between urinary NTx concentration and other variables including age, duration of diabetes, blood pressure, serum lipid concentration, hemoglobin A(1c), and body mass index were evaluated. Urinary NTx concentrations were 27.8 (26.4-29.3) nmol of bone collagen equivalent per millimole of creatinine, correlating inversely with serum free testosterone (r = -0.263, P < .0001). Multiple regression analysis identified serum free testosterone (beta = -.292, P < .0001), hemoglobin A(1c) (beta = .144, P = .0404), and smoking status (beta = .143, P = .0402) as independent determinants of urinary NTx. In conclusion, serum free testosterone concentration correlated inversely with urinary NTx concentration, which may partly account for an observed link between osteoporosis and cardiovascular disease in men with type 2 diabetes mellitus.     

Relation between serum high molecular weight adiponectin and serum ferritin or prohepcidin in patients with type 2 diabetes

An increase of serum ferritin, an indicator of body iron store, is associated with insulin resistance and with an increased risk of type 2 diabetes in the general population. A low serum adiponectin is also associated with insulin resistance. Recently, hepcidin was identified as a regulator of iron metabolism. We investigated whether serum adiponectin was associated with serum ferritin or prohepcidin, a precursor of hepcidin, in healthy subjects and patients with type 2 diabetes. We studied 65 healthy subjects and 104 patients with type 2 diabetes. A serum ferritin concentration ≥ 300 ng/ml for men or ≥ 150 ng/ml for women was defined as hyperferritinemia. Serum ferritin was significantly higher and serum prohepcidin was significantly lower in diabetic patients than in control subjects. Serum total and high molecular weight (HMW) adiponectin correlated negatively with serum ferritin in control subjects or diabetic patients, while serum total and HMW adiponectin correlated positively with serum prohepcidin in diabetic patients, but not in control subjects. Serum total and HMW adiponectin were lower in patients with hyperferritinemia than in those without it. In conclusion, serum ferritin was increased in type 2 diabetic patients, while serum prohepcidin was decreased. A high serum ferritin was associated with insulin resistance, and with low serum total and HMW adiponectin in patients with type 2 diabetes.