2型糖尿病患者外周血单核细胞三磷酸腺苷结合盒转运体A1的变化及其意义

目的初步分析2型糖尿病患者血脂及外周血单核细胞三磷酸腺苷结合盒转运体A1(ABCA1)的变化,以及2型糖尿病患者ABCA1的变化与血脂、糖代谢的相关性。方法分别取2型糖尿病组及对照组(各40例)外周血中的单核细胞,利用抗原、特异性一抗及PE荧光标记的二抗间的相互反应,在流式细胞仪上检测氧化型低密度脂蛋白(ox-LDL)刺激前后ABCA1的表达变化,同时在空腹情况下检测血脂及空腹血糖(FPG)、糖化血红蛋白(HbA1C)。分析2型糖尿病患者ABCA1表达变化与年龄、血脂水平和糖代谢的相关性。结果与对照组相比,2型糖尿病组甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和极低密度脂蛋白胆固醇(VLDL-C)即非高密度脂蛋白胆固醇(NHDL-C)]水平显著升高(P<0.01),血清高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(apoA1)的水平及外周血单核细胞ABCA1的表达显著降低(P<0.01)。ox-LDL刺激24h后,2型糖尿病组ABCA1的变化量(刺激后表达量/初始表达量)明显高于对照组ABCA1的变化量(P<0.01),但最终表达量仍显著低于对照组(P<0.01);ox-LDL刺激后2型糖尿病组AB-CA1的改变量与HDL-C呈正相关。结论2型糖尿病患者体内存在受损的胆固醇逆转运及血脂谱,具有诱发动脉粥样硬化(AS)和冠心病的基础。

Dynmic changes in ATP-binding cassette transporter A1 in peripheral blood monocytes of patients with type 2 diahetes mellitus

Objective To analyze the dynamic changes in blood lipids and ATP-binding cassette transporter A1 (ABCA1) in peripheral blood monocytes of the patients with type 2 diabetes, and explore the correlations between ABCA1 expression and blood lipids levels and glycometabolism. Methods Human monocytes were isolated from the patients with type 2 diabetes (n=40) and from the healthy individuals (n=40) serve as normal control. ABCA1 was labeled by immune reaction PE fluorescence, then the changes in ABCA1 expression before and after being incubated with the ox-LDL were investigated by flow cytometer. The blood lipid levels, fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) levels in the patients of type 2 diabetes group were determined, and the correlations between ABCA1 and age, blood lipid, and glycometabolic levels were analyzed. Results Plasma levels of triglyceride, non-high density lipoprotein cholesterol (NHDL-C) low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C)] in the patients of type 2 diabetes group were significantly higher than that in control group (P<0.01). Plasma levels of high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA-1) and ABCA1 expression in peripheral blood monocytes were significantly decreased in diabetic patients than that in control group (P<0.01), and the increase rate of ABCA1 expression stimulated by ox-LDL for 24 hours (ABCA1) was significantly greater in the patients of type 2 diabetes group than that in control group (P<0.01). But the ultimate expression of ABCA1 in the patients of type 2 diabetes group was still lower than that in control group (P<0.01). A positive correlation existed between stimulated expression of ABCA1 and HDL-C level. Conclusions The decreased reverse cholesterol transport and abnormal lipid spectrum in patients with type 2 diabetes may induce atherosclerosis and coronary heart disease.