Persistent endothelial dysfunction is related to elevated C-reactive protein (CRP) levels in Type II diabetic patients after acute myocardial infarction

The atherosclerotic process is an ongoing dynamic and progressive state arising from endothelial dysfunction and inflammation. Although suffering from an acute coronary artery disease, patients with Type II diabetes have a poor outcome compared with non-diabetic patients, which may only partly be explained by traditional risk factors. Our purpose was to compare non-traditional risk factors, such as endothelial function, C-reactive protein (CRP) and adiponectin, in Type II diabetic and non-diabetic patients following AMI (acute myocardial infarction). Twenty Type II diabetic patients were compared with 25 non-diabetic patients at baseline (1-3 days from the onset of chest pain) and at 60 days follow-up after an AMI. Using high-resolution ultrasound, brachial artery responses to FMD (flow-mediated vasodilatation; endothelium-dependent vasodilatation) and NTG (nitroglycerine-induced vasodilatation; endothelium-independent vasodilatation) were measured. Plasma levels of CRP and adiponectin were measured by ELISA. At baseline, FMD (1.9 compared with 3.2%; P=0.22) and CRP levels (6.95 compared with. 5.51 mg/l; P=0.40) did not differ between Type II diabetic and non-diabetic patients, whereas adiponectin levels were lower in Type II diabetic patients (2.8 compared with 5.0 ng/ml; P<0.05). At 60 days follow-up, there were significant differences in FMD (1.5 compared with 4.1%; P<0.02), CRP (4.23 compared with 1.46 mg/ml; P<0.01) and adiponectin (3.3 compared with 5.3 ng/ml; P<0.05) levels between Type II diabetic and non-diabetic patients. In contrast, NTG responses improved in both groups between baseline and follow-up (Type II diabetic patients, 9.7 compared with 13.2% respectively, P<0.05; non-diabetic patients, 7.9 compared with 12.4% respectively, P<0.01). These results show a persistent endothelium-dependent dysfunction and inflammatory activity in patients with Type II diabetes, but not in non-diabetic patients, after AMI. These findings may, in part explain, the poor outcome in coronary artery disease seen in Type II diabetes.     

血清脂联素和抵抗素与初诊2型糖尿病的相关性研究

目的：探讨脂联素和抵抗素与2型糖尿病（T2DM）的关系。方法：对39例初诊T2DM患者做研究对象，选37例健康人做对照。采用酶联免疫测定法测定空腹血清脂联素和抵抗素浓度，并测定各组的空腹血糖、胰岛素、尿酸和血脂水平等；用HOMA—IR评价胰岛素抵抗，分析各指标间的相关性。结果：DM组血清脂联素浓度（3．66±0．91）ng／ml低于正常对照组（5．26±0．78）ng／ml，差异有显著性（P〈0．01）。DM组血清抵抗素浓度（6．10±0．43）μg／ml与正常对照组（6．09±0．47）μg／ml差异无显著性。在DM组，采用相关分析发现，血清脂联素浓度与患者收缩压、舒张压、年龄、病程、空腹胰岛素、体重指数、胆固醇、低密度脂蛋白胆固醇、HOMAIR呈负相关，与脂蛋白A1正相关；血清抵抗素与年龄、病程、收缩压、舒张压、甘油三酯呈正相关；与脂蛋白A1呈负相关，与体重指数、HOMAIR等不相关。结论：脂联素水平的下降与DM发病有关，而抵抗素与之无关。     

Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock

BACKGROUND: Inflammatory response is an important feature of acute coronary syndromes and myocardial infarction (MI). The prognostic value of proinflammatory cytokines in patients with acute MI complicated by cardiogenic shock is unknown. METHODS AND RESULTS: In 41 patients admitted with acute MI (age 60 +/- 11 years, six females, 19 Killip class IV) serial plasma concentration of tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6) and interleukin 1 receptor antagonist (IL-1Ra) were measured. Seven patients with cardiogenic shock (CS) developed a systemic inflammatory response syndrome (SIRS). Patients with CS-particularly those who developed SIRS-showed significantly higher cytokine levels than patients with uncomplicated MI. In patients with CS and SIRS peak levels of IL-1Ra were 223,973 pg/ml, IL-6 252.8 pg/ml and TNF-alpha 7.0 pg/ml. In CS without SIRS IL-1Ra levels were 19,988 pg/ml, IL-6 109.3 pg/ml and TNF-alpha 3.8 pg/ml. In uncomplicated MI peak IL-1Ra levels were 1,088 pg/ml, IL-6 34.1 pg/ml and TNF-alpha 2.6 pg/ml. CONCLUSIONS: The inflammation-associated cytokines TNF-alpha, IL-6 and IL-1Ra are significantly elevated in patients with MI complicated by CS when compared to patients with uncomplicated MI. Among shock-patients IL-1Ra levels are promising diagnostic markers for early identification of patients developing SIRS, heralding a poor outcome.     

细菌性肝脓肿合并2型糖尿病患者血清炎性因子及外周血T细胞亚群的变化分析

目的探讨2型糖尿病合并细菌性肝脓肿患者血清炎性因子、外周血T淋巴细胞亚群的变化及其意义。方法分析重庆市巴南区人民医院2015年1月至2018年7月收治的细菌性肝脓肿患者112例的病例资料,其中合并2型糖尿病患者41例(糖尿病组),未合并2型糖尿病患者71例(非糖尿病组),比较2组治疗前、治疗后的血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素6(IL-6)、外周血中T淋巴细胞亚群(CD3^+、CD4^+、CD8^+T细胞)的水平。结果糖尿病组患者血清PCT、CRP、IL-6水平高于非糖尿病组(均P<0.05),CD3^+、CD4^+T细胞水平及CD4^+/CD8^+值低于非糖尿病组(均P<0.05);CD8^+T细胞水平与非糖尿病组相比,差异无统计学意义(P>0.05)。糖尿病组和非糖尿病组患者在治疗14 d后的血清PCT、CRP、IL-6水平较本组治疗前显著降低(均P<0.05),CD3^+、CD4^+T细胞水平、CD4^+/CD8^+值较本组治疗前显著升高(均P<0.05)。结论与单纯细菌性肝脓肿患者比较,细菌性肝脓肿合并2型糖尿病患者血清PCT、CRP、IL-6水平升高更加显著,免疫功能损害更加严重。     

EECP联合高压氧对不稳定型心绞痛患者血清TSP-1、Cat S和IL-1β水平的影响

目的观察增强型体外反搏(EECP)联合高压氧治疗不稳定型心绞痛的疗效,以及对血清血小板反应蛋白-1(TSP-1)、组织蛋白酶S(Cat S)和白细胞介素(IL)-1β水平的影响。方法选择2017年1月至2019年12月在上海市闵行区中西医结合医院诊治的不稳定型心绞痛患者106例,根据随机数字表法将患者分为观察组和对照组,每组53例。对照组予以高压氧治疗,观察组在对照组的基础上使用EECP治疗。观察两组治疗后的疗效,治疗前后症状、总胆固醇(TG)、三酰甘油(TC)和低密度脂蛋白胆固醇(LDL-C)、肱动脉血流介导性舒张功能(FMD)、肱-踝动脉脉搏波传导速度(baPWV)、颈-股动脉脉搏波传导速度(cfPWV)、TSP-1、Cat S和IL-1β水平的变化。结果观察组的总有效率为90.57%,对照组的总有效率为71.70%,观察组的疗效明显优于对照组(P<0.05)。两组治疗前心绞痛持续时间、心绞痛发作频率、心肌缺血总负荷、TG、TC、LDL-C、肱动脉FMD、baPWV、cfPWV、TSP-1、Cat S和IL-1β水平差异无统计学意义(P>0.05),治疗后两组的心绞痛持续时间缩短(P<0.05),心绞痛发作频率、心肌缺血总负荷、TG、TC、LDL-C、baPWV、cfPWV、TSP-1、Cat S和IL-1β水平较治疗前明显降低(P<0.05),两组肱动脉FMD较治疗前明显升高(P<0.05),观察组与对照组比较,改变更加明显(P<0.05)。结论EECP联合高压氧治疗不稳定型心绞痛的疗效显著,能够降低血脂水平,改善动脉血管弹性,可能与降低血清TSP-1、Cat S和IL-1β水平有关。     

IL-19在2型糖尿病患者中的 表达及与血管病变的关系

目的 探讨白细胞介素-19(IL-19)水平在2型糖尿病(T2DM)患者中的表达以及与血管病变的关系。方法 选取T2DM患者120例(其中并发大血管病变32例,微血管病变52例,无血管病变36例),同期选择健康体检者50例为对照组,分别检测研究对象中IL-19,空腹血糖(FBG),胰岛素(FINS)和糖化血红蛋白(HbA1c)水平,并与对照组作比较。结果 T2DM组中IL-19水平显著高于正常对照组(41.9±11.9 pg/ml vs 16.2±8.5 pg/ml),差异有统计学意义(t=7.56,P<0.05)。T2DM并发大血管病变组和微血管病变组IL-19水平显著高于无血管病变组(t=4.57,3.26; 均P<0.05),且与病变血管数量有关。IL-19与胰岛素抵抗(HOMA-IR),HbA1c呈显著正相关(r分别为0.523和0.491,均P<0.01)。结论T2DM患者中IL-19水平显著升高,与HbA1c和HOMA-IR抵抗密切相关,并且IL-19可能参与了T2DM血管病变的发生和发展。     

Impaired flow-mediated dilatation response in uncomplicated Type 1 diabetes mellitus: influence of shear stress and microvascular reactivity

Impaired FMD (flow-mediated dilatation) has traditionally been recognized as an indirect marker of NO bioactivity, occurring in disease states such as DM (diabetes mellitus). Endothelium-dependent FMD is a homoeostatic response to short-term increases in local shear stress. Microvascular dysfunction in DM influences blood flow velocity patterns. We explored the determinants of the FMD response in relation to evoked DSS (diastolic shear stress) and forearm microcirculation haemodynamics by quantifying changes in Doppler flow velocity waveforms between groups. Forty patients with uncomplicated Type?1 DM and 32 controls underwent B-mode and Doppler ultrasound scanning to interrogate the brachial artery. Postischaemic Doppler velocity spectral envelopes were recorded and a wavelet-based time-frequency spectral analysis method was employed to track change in distal microcirculatory haemodynamics. No difference in baseline brachial artery diameter was evident between the groups (4.15 compared with 3.94 mm, P=0.23). FMD was significantly impaired in patients with Type?1 DM (3.95 compared with 7.75%, P<0.001). Endothelium-independent dilatation in response to GTN (glyceryl trinitrate) was also significantly impaired (12.07 compared with 18.77%, P<0.001). DSS (dyn/cm2) was significantly reduced in the patient group (mean 20.19 compared with 29.5, P=0.001). Wavelet interrogation of postischaemic flow velocity waveforms identified significant differences between groups. In conclusion, DSS, microcirculatory function and endothelium-independent vasodilatation in response to GTN are important determinants that impact on the magnitude of FMD response and are impaired in patients with Type?1 DM. Impaired FMD response is multifactorial in origin and cannot be attributed solely to a diminished NO bioavailability.     

Do surrogate markers for adiposity relate to cytokines in adolescents?

PURPOSE: To determine the associations between field-collected surrogates of adiposity and concentrations of resistin, tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and adiponectin in youth. METHODS: Cross-sectional data from 60 normal weight and 60 overweight adolescents, ages 10-14 years, were retrospectively examined. Body mass index (BMI) percentile, sum of subscapular and triceps skinfolds (SSF), and waist circumference (WC) were used to classify weight status (BMI) or adiposity (SSF and WC). Percentiles for each surrogate were used for comparison groups. Fasting TNF-alpha, IL-6, resistin, and adiponectin concentrations were measured in plasma. RESULTS: Multiple regression models, controlling for sex and ethnicity, indicated that TNF-alpha was associated with BMI percentile (R(2) = 0.107, P < 0.05) and SSF (R(2) = 0.085, P < 0.05), whereas resistin was associated with SSF (R(2) = 0.118, P < 0.05). Adiponectin was associated with all 3 adiposity markers: BMI percentile (R(2) = 0.298, P < 0.05), SSF (R(2) = 0.297, P < 0.05), and waist (R(2) = 0.278, P < 0.05). Analyses of variance indicated higher TNF-alpha and lower adiponectin concentrations in youth with a BMI higher than the 95th percentile (P = 0.014; P < 0.001) or SSF higher than the 95th percentile (P = 0.025; P < 0.001). Youth with WC higher than the 90th percentile had higher resistin (P = 0.029), higher IL-6 (P = 0.028), and lower adiponectin (P < 0.001) concentrations. CONCLUSIONS: Of the 3 surrogates examined, differences in cytokine concentrations were mostly observed in youth who had WC percentiles higher than the 90th percentiles versus WC lower than the 75th percentiles. Alternatively, from the multiple-regression models SSF, an estimate of subcutaneous adiposity was the surrogate most consistently related to all cytokines, although the degrees of associations were low. The results suggest that although some surrogates were more strongly associated to certain cytokines, WC and SSF seemed more closely associated with cytokines than a BMI percentile indicating obesity.     

Influence of age and visceral fat area on plasma adiponectin concentrations in women with normal glucose tolerance

BACKGROUND: Age-related adiponectin concentration has been discrepantly reported. We investigated the distribution of adiponectin by age in healthy women with normal glucose tolerance (NGT) and the relationship of adiponectin with visceral fat area (VFA). METHODS: Three-hundred fifty-nine women (age: 38+/-0.6 years, BMI: 26.5+/-0.2 kg/m(2)) were categorized into 4 age-groups: 20-29, 30-39, 40-49, and 50-64 years. Computed tomography was performed to measure abdominal fat area and adiponectin, TNF-alpha, interleukin-6 (IL-6), CRP, insulin, free fatty acid (FFA), and blood urea nitrogen (BUN) were determined. RESULTS: No significant differences were observed in BMI, total body fat percent and concentrations of insulin, IL-6 and CRP among age-groups. Waist circumference, total fat area at L4, and FFA were significantly higher only in postmenopausal women than in previous decades of premenopausal women. VFA, adiponectin and TNF-alpha concentrations are significantly higher in older women than in younger women. Higher adiponectin concentration in older women was clearly shown even after adjustment for VFA (P<0.05). Age per se was positively correlated with plasma adiponectin concentrations (r=0.21, P<0.001) and these relationship became stronger (r=0.36, P<0.001) after controlled for VFA. VFA was negatively correlated with adiponectin (r=-0.16, P<0.01) in total studied population. However, when analyzed subgroups separately, a strong negative correlation (r=-0.37, P<0.001) was found in younger women (<40 years), while a weak significant relationship (r=-0.18, P<0.05) was found in older women (> or =40 years). In a multiple stepwise regression model to predict adiponectin, only age and VFA remained in the model at P<0.001. CONCLUSIONS: We observed a significant positive relationship between plasma adiponectin and age, even after adjustment for visceral adiposity. These associations suggest that adiponectin concentrations are affected by visceral adiposity, with additional independent effects of age.     

Adiponectin, T-cadherin and tumour necrosis factor-alpha in damaged cardiomyocytes from autopsy specimens

This study determined the presence of adiponectin, T-cadherin (an adiponectin receptor) and tumour necrosis factor-alpha (TNF-alpha) in damaged myocytes from autopsied patients with acute or old myocardial infarction (MI) or dilated cardiomyopathy (DCM), using immunohistochemical staining. The enrolled patients included eight with acute MI, six with old MI and seven with DCM. Four autopsied individuals with no cardiac lesions were also enrolled as controls. Adiponectin and TNF-alpha were not observed in normal myocytes from control subjects, but T-cadherin was weakly detected. Immunoreactivity for adiponectin and T-cadherin was observed at the periphery of damaged myocytes from MI and DCM patients; intracellular reactivity for TNF-alpha was also seen. There were no statistically significant differences in the degree of reactivity for each molecule in the myocytes between the MI and DCM patients. These results suggest that the presence of adiponectin and TNF-alpha in damaged myocytes may contribute to the processes of myocardial injury occurring in MI and DCM.     

超声对2型糖尿病上下肢动脉内皮功能损伤的对比研究

目的 应用高频超声分别检测并比较2型糖尿病(2DM)患者肱动脉和腘动脉血流介导的内皮舒张功能(Flow-mediated vasodilation,FMD),为临床提供其内皮功能障碍的可靠依据.方法 对50例2DM患者和65例正常人,应用高频超声分别检测肱动脉和腘动脉基础内径、基础状态峰值流速、反应性充血后最大血管内径、峰值流速,分别计算FMD并进行比较.结果 (1)2DM组肱动脉及腘动脉FMD均明显小于正常对照组[(肱动脉:(4.03±1.12)% vs (8.90±2.02)%,P<0.01];腘动脉:[(3.64±1.30)% vs (5.91±1.05)%,P<0.01)];(2)2DM患者腘动脉FMD明显小于肱动脉FMD[(3.64±1.30)% vs (4.03±1.12)%,P<0.01)].结论 2DM时内皮依赖性血管舒张功能明显受损,尤以下肢FMD受损更明显.     

2型糖尿病患者的心率减速力及其影响因素分析

目的观察2型糖尿病(T2DM)患者的心率减速力(DC)及其影响因素。方法选择本院2017年4月至2019年10月收诊的69例T2DM患者为研究对象。采用12导联动态心电记录仪监测和计算患者的DC值,收集C肽、HbA1c、FBG、LDL-C、HDL-C、TG、TC、PCT、IL-18、CRP水平的相关资料。按照DC值大小对患者进行分组(DC>4.5 ms,视作低危值;DC在2.5~4.5 ms,视作中危值;DC<2.5 ms,视作高危值)。比较不同组别患者的血糖、血脂、炎症因子水平,通过多因素Logistic回归分析观察影响T2DM患者DC值的因素。结果按照DC值不同将69例T2DM患者分为A组(低危值,24例)、B组(中危值,22例)、C组(高危值,23例)。单因素分析结果显示,三组的HbA1c、FBG、LDL-C、TG、TC、PCT、IL-18、CRP水平有显著差异,且A组相似文献   

糖尿病肾病患者肱动脉与胭动脉血管内皮舒张功能对比性研究

目的：以高频超声比较糖尿病肾病Ⅴ期患者肱动脉与腘动脉血管内皮舒张功能的差异性.方法：分别选择健康志愿者（NC组）、2型糖尿病（DM组）和糖尿病肾病Ⅴ期透析前（DKD-Ⅴ组）的患者各20例. 利用高频彩色多普勒超声测量肱动脉及腘动脉血管基础状态及加压后血管内径和峰值流速,并计算血流介导的扩张值（FMD）. 比较肱动脉及腘动脉FMD及峰值流速的差异.结果：肱动脉FMD（％）、腘动脉FMD（％）,NC组、DM组、DKD-V组显著性减少（P＜0.05）;肱动脉与腘动脉FMD（％）比较,NC组、DM组、DKD-V组显著性减少（P＜0.05）;肱动脉与胭动脉FMD差值（％）,NC组、DM组、DKD-V组显著性增加（P＜0.05）.结论：DKD-V组患者血管内皮舒张功能障碍重于单纯糖尿病患者,且腘动脉血管内皮舒张功能障碍进展速度大于肱动脉.     

糖尿病肾病与抵抗素、MMP-2的相关性研究

目的 探讨血清抵抗素、超敏C反应蛋白（Hs-CRP）和金属蛋白酶（MMP-2）在2型糖尿病肾病发生发展中的作用.方法 测定正常人30例、2型糖尿病组（单纯糖尿病组30例、微量白蛋白尿组30例、蛋白尿组30例）患者共120例研究对象的血清抵抗素、Hs-CRP和MMP-2水平,并分析其与尿微量白蛋白等指标的关系.结果 2型糖尿病（diabetes mellitus, DM）组血清抵抗素和Hs-CRP水平明显高于正常对照组（P〈0.01）.糖尿病组中微量白蛋白尿组和蛋白尿组两个亚组血清抵抗素及Hs-CRP水平明显高于单纯糖尿病组（P〈0.01）.抵抗素与Hs-CRP和尿微量白蛋白正相关（r=0.67,0.61 P值均〈0.01）.DM组血清MMP-2水平明显低于正常对照组（P〈0.01）.糖尿病组中微量白蛋白尿组和蛋白尿组两个亚组血清MMP-2水平明显低于单纯糖尿病组（P〈0.01） MMP-2和血清抵抗素.Hs-CRP、尿微量白蛋白呈负相关（r=-0.64,-0.60,-0.58 P值均〈0.01）.结论 抵抗素、Hs-CRP、MMP-2与糖尿病肾病发生、发展有关,检测血清其水平可能对早期诊断和评估糖尿病肾病有作用.     

炎症因子Lp-PLA2、IL-18与糖尿病足溃疡的相关性研究

目的检测糖尿病足(DF)溃疡患者脂蛋白相关磷脂酶A2(Lp-PLA2)和白细胞介素(IL)-18水平,探讨Lp-PLA2、IL-18水平与DF疾病进展的关系。方法2016年1-12月该院内分泌科收治的2型糖尿病(T2DM)患者185例纳入本研究,其中合并足部溃疡的T2DM患者135例(DF组),无足部溃疡的T2DM患者(T2DM组)50例,另选择体检健康者30例为对照组。采集空腹静脉血检测Lp-PLA2、IL-18、IL-1β、肿瘤坏死因子α(TNF-α)、纤溶酶原激活物抑制剂1(PAI-1)、纤维蛋白原(FIB)、C-反应蛋白(CRP)、白细胞总数(WBC)和中性粒细胞百分比(NEU%)等炎症指标;同时检测糖化血红蛋白(HbA1c)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)等基线指标。将DF组参照Wagner分级方法分为WagnerⅠ级(21例)、WagnerⅡ级(34例)、WagnerⅢ级(60例)和WagnerⅣ级(20例)。采用SPSS17.0软件进行统计分析。结果Lp-PLA2和IL-18水平在对照组、T2DM组和DF组3组间逐步增高(P<0.05)。WagnerⅣ级组Lp-PLA2、IL-18水平高于其余3组(P<0.05)。单因素分析表明年龄、糖尿病病程、Lp-PLA2、IL-18、FIB、CRP、WBC、NEU%是DF发生的危险因素;多因素Logistic回归分析表明,Lp-PLA2、IL-18、FIB和CRP是DF发生的独立危险因素。结论血清Lp-PLA2、IL-18水平增高和DF疾病进展有关,检测Lp-PLA2、IL-18水平有助于评估DF严重程度,通过动态检测还有助于了解疾病进展和疗效。     

Endothelial dysfunction and increased oxidative stress in mitochondrial diseases

MDs (mitochondrial diseases) are a clinically heterogeneous group of disorders characterized by impairment of the respiratory chain function with altered oxidative phosphorylation. We tested the hypothesis that the function of vascular endothelium is affected by increased oxidative stress in MDs. A total of 12 patients with MDs and pair-matched controls were studied. Endothelial function was assessed by measuring FMD (flow-mediated vasodilation) of brachial and common femoral arteries. The test was repeated after vitamin C (500 mg, twice a day) and E (400 mg, once a day) supplementation for 30 days and 90 days after vitamin withdrawal. FMD was reduced in patients compared with controls [AUC/τ (time-averaged area under the curve) for the brachial artery, 1.05±0.24 compared with 4.19±0.59% respectively, P<0.001; AUC/τ for the femoral artery, 0.98±0.19 compared with 2.36±0.29% respectively, P=0.001; values are means±S.E.M.] and correlated (brachial artery) with plasma lactate (r=-0.63, P<0.01). Urinary 8-iso-PGF2α (8-iso-prostaglandin F2α) was higher in patients than controls (505.6±85.9 compared with 302.5±38.7 pg/mg of creatinine; P<0.05) and correlated with plasma lactate (r=0.70, P<0.05). Immunohistochemical analysis showed 8-iso-PGF2α staining in MD-affected striated muscle cells and in blood vessels in muscle biopsies of patients. Antioxidant vitamins transiently restored FMD in patients [ΔAUC/τ (change in AUC/τ) for the brachial artery, +1.38±0.49%, P<0.05; ΔAUC/τ for the femoral artery, +0.98±0.24%, P<0.01] but had no effect on FMD in controls (brachial artery, -1.3±0.63%; and common femoral artery, -0.58±0.30%), thus abolishing the differences between patients and controls. The results of the present study indicate that oxidative stress is increased and is, at least partly, responsible for endothelial dysfunction in MDs.     

The serum profile of adipokines in naïve patients with diabetes mellitus type 2 and obesity

Background: The aim of this study was to explore the relationship of serum profile of adipokines with cardiovascular risk factors and anthropometric parameters in patients with diabetes mellitus type 2. Subjects: A population of 108 obese patients with DM2 was analyzed. A complete biochemical anthropometric and nutritional evaluation was performed. Results: In the analysis with leptin as a dependent variable, the IL‐6 and glucose levels remained in the model (F = 6.2; P<0.05), with an increase of 5.8 (CI 95%:2.7–7.6) ng/ml with each 1 pg/ml of IL‐6 and of 5.2 (CI95%:2.5–5.8) ng/ml with each 1 mg/dl of glucose. In a second model with adiponectin as a dependent variable, the BMI remained in the model (F = 3.77;P<0.05), with an decrease of ?3.77 (CI 95%:0.53–7.1) ng/ml with each 1 point of BMI. In the third multivariate analysis with IL‐6 as a dependent variable, the glucose level remained in the model (F = 10.1; P<0.01), with an increase of 0.09 (CI95%:0.06–0.12) pg/ml with each 1 mg/dl of glucose. In the fourth multivariate analysis with resistin as a dependent variable, the CRP remained in the model (F = 2.51; P<0.05), with an increase of 0.28 (CI 95%:0.08–0.48) pg/ml with each 1 mg/dl of CRP. Conclusion: Serum profile of adipokines is associated with different risk factors in diabetic obese patients. J. Clin. Lab. Anal. 25:409–413, 2011. © 2011 Wiley Periodicals, Inc.     

吡格列酮对肥胖2型糖尿病患者血清脂联素及CRP的影响

目的 探讨吡格列酮(PGZ)对肥胖2型糖尿病(T2DM)患者血清脂联素(APN)及C反应蛋白(CRP)水平影响.方法 用酶联免疫吸附法检测69例T2DM患者和50例正常对照组的血清APN及CRP水平,用随机双盲法比较69例肥胖T2DM患者用常规治疗和PGZ干预治疗12周后的血清APN、CRP水平.结果 肥胖T2DM组与正常对照组比较,血清APN水平降低(P<0.01),CRP升高(P<0.01);应用PGZ治疗后,患者血清APN水平显著升高,CRP显著降低(P<0.05),而常规治疗组治疗前后无显著性差异(P>0.05).结论 PGZ能提高肥胖T2DM患者血清APN水平,并降低血清CRP水平.     

2型糖尿病并发心血管病变患者血清抵抗素和超敏C反应蛋白水平变化

目的探讨2型糖尿病(T2DM)并发心血管病变患者血清抵抗素和超敏C反应蛋白(hs-CRP)水平的变化及其临床意义。方法将100例T2DM患者按病情分为心血管病变组及单纯T2DM组各50例,分别检测血清抵抗素及hs-CRP水平,并以50例健康人作为对照。结果 T2DM并发心血管病变患者血清抵抗素和hs-CRP水平分别为(16.99±7.13)μg/L和(4.97±2.88)mg/L,单纯T2DM组为(12.98±6.15)μg/L和(3.61±1.49)mg/L,均明显高于健康对照组(9.32±4.46)μg/L及(1.34±0.95)mg/L(P<0.01),且抵抗素与hs-CRP水平呈正相关(P<0.05)。结论血清抵抗素及hs-CRP水平与T2DM患者并发心血管病变密切相关,对其动态检测可作为预测T2DM并发心血管病变危险性的重要实验室指标。     

伊伐布雷定对2型糖尿病合并心力衰竭患者的心率变应性及TNF-α、IL-6、CRP水平的影响

目的分析伊伐布雷定治疗2型糖尿病(T2DM)合并心力衰竭(简称心衰)患者对心率变应性(HRV)及肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平的影响。方法选取2016年5月至2018年12月该院内分泌科T2DM合并心衰患者100例,随机抽样法分为对照组(48例)和观察组(52例)。对照组行降糖抗心衰标准治疗,观察组于对照组基础上,口服伊伐布雷定缓释片治疗,3个月后对比两组患者心功能、HRV变化,前脑钠肽(pro-BNP)、空腹血糖水平(FPG)、CRP、TNF-α和IL-6水平。结果治疗前两组心功能指标、HRV、FPG、pro-BNP、CRP、TNF-α和IL-6比较,差异无统计学意义(P>0.05);治疗后观察组心功能明显改善,HRV升高,CRP、TNF-α、IL-6、FPG和pro-BNP水平均下降,与对照组比较,差异均有统计学意义(P<0.05);观察组治疗有效率与对照组比较,差异有统计学意义(P<0.05)。结论伊伐布雷定可有效改善T2DM合并心衰患者的心功能障碍,可提高HRV,降低pro-BNP水平,稳定T2DM血糖水平,降低相关炎症因子水平,临床应用价值较高。