diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM7928diaendo-7928Research ArticleВопросы патогенезаPathogenesisКлинические и метаболические факторы, ассоциированные с хроническим воспалением низкой интенсивности, у больных сахарным диабетом 2 типаClinical and metabolic factors associated with chronic low-grade inflammation in type 2 diabetic patientshttps://orcid.org/0000-0002-5407-8722КлимонтовВадим ВалерьевичKlimontovVadim V.

д.м.н., профессор, заведующий лабораторией эндокринологии, зам. директора по научной работе

klimontov@mail.ruТянНадежда ВикторовнаTyanNadezda V.vitae-82@mail.ruФазуллинаОльга НиколаевнаFazullinaOlga N.fazullina@ngs.ruМякинаНаталья ЕвгеньевнаMyakinaNatalia E.nmyakina@list.ruЛыковАлександр ПетровичLykovAlexander P.aplykov2@mail.ruhttps://orcid.org/0000-0001-7385-6270КоненковВладимир ИосифовичKonenkovVladimir I.vikonenkov@gmail.comФГБНУ Научно-исследовательский институт клинической и экспериментальной лимфологииРоссияScientific Institute of Clinical and Experimental LymphologyRussian Federation201609092016194Том 19, №4(2016)295302Copyright © Климонтов В.В., Тян Н.В., Фазуллина О.Н., Мякина Н.Е., Лыков А.П., Коненков В.И., 20162016Климонтов В.В., Тян Н.В., Фазуллина О.Н., Мякина Н.Е., Лыков А.П., Коненков В.И.Klimontov V.V., Tyan N.V., Fazullina O.N., Myakina N.E., Lykov A.P., Konenkov V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/7928Цель

Цель. Выявить клинические и метаболические факторы, ассоциированные с концентрацией С-реактивного белка (hsCRP) и α1-кислого гликопротеина (α1-AGP) в сыворотке крови, у больных сахарным диабетом (СД) 2 типа.

Материал и методы

Материал и методы. Обследовано 210 пациентов с СД 2 типа (СД2). Уровень hsCRP и α1-AGP измеряли методом иммуноферментного анализа и сравнивали с контролем (30 здоровых лиц). Между уровнями острофазовых белков и демографическими, антропометрическими, биохимическими, гематологическими параметрами, массой жировой ткани, параметрами вариабельности глюкозы (ВГ) определяли наличие сопряженностей. Исследование массы жировой ткани проводили с помощью двухэнергетической рентгеновской абсорбциометрии. Параметры ВГ: среднюю амплитуду колебаний гликемии (MAGE), индекс длительного повышения гликемии (CONGA), J-индекс, M-value, среднечасовую скорость изменения гликемии (MAG) рассчитывали по данным непрерывного мониторинга глюкозы.

Результаты

Результаты. У обследованных больных СД в сравнении с контролем зафиксировано достоверное (р<0,0001) повышение уровня hsCRP и α1-AGP. Установлены прямые корреляции между концентрацией hsCRP и общей массой жировой ткани, массой жировой ткани на туловище и в зоне android (r=0,34, r=0,28 и r=0,31 соответственно, p<0,00004). Концентрация α1-AGP не показала связи с массой жировой ткани, но коррелировала со средним уровнем гликемии, CONGA, M-value и MAG (r=0,38, r=0,36, r=0,43 и r=0,4 соответственно, p<0,0001). Больные с высоким уровнем hsCRP (>75 процентиля), в сравнении с пациентами с низким уровнем (<25 процентиля), имели больший индекс массы тела (0,00009), массу жира на туловище (р=0,04) и в зоне android (р=0,03). Высокий (>75 процентиля) уровень α1-AGP был ассоциирован с отношением альбумин/креатинин мочи (р=0,01) и индексами ВГ (M-value: p=0,02, MAG: p=0,04). Относительное количество лимфоцитов в периферической крови было ниже у больных с высоким уровнем hsCRP (р=0,007) и α1-AGP (р=0,01).

Заключение

Заключение. У больных СД2 наблюдается повышение концентрации белков острой фазы (hsCRP и α1-AGP) в сыворотке крови. Уровень hsCRP взаимосвязан с количеством жировой ткани, в то время как уровень α1-AGP ассоциирован с краткосрочной ВГ. Результаты согласуются с представлениями о вкладе ожирения и повышенной ВГ в развитие хронического воспаления низкой интенсивности у больных СД2.

Aim

Aim. To identify the clinical and metabolic factors associated with serum concentration of high sensitivity C-reactive protein (hsCRP) and α1-acid glycoprotein (α1-AGP) in patients with type 2 diabetes.

Material and methods

Material and methods. The study involved 210 patients with type 2 diabetes. Levels of hsCRP and α1-AGP were measured using ELISA and compared with those of the control (30 healthy normal individuals). Levels of acute-phase proteins, fat mass and glucose variability (GV) were compared among demographic, anthropometric, biochemical and haematological parameters. The fat mass was determined with Dual-energy X-ray absorptiometry (DEXA). GV parameters including mean amplitude of glycaemic excursions, continuous overlapping net glycaemic action (CONGA), J-index, M-value and mean absolute glucose change (MAG) were derived from continuous glucose monitoring.

Results

Results. Levels of hsCRP and α1-AGP significantly increased (p < 0.0001) in patients with diabetes compared with controls. hsCRP level positively correlated with total, truncal and android fat (r = 0.34, r = 0.28 and r = 0.31; respectively, p < 0.00004). α1-AGP level showed no relationship with fat mass but positively correlated with mean glucose, CONGA, M-value and MAG (r = 0.38, r = 0.36, r = 0.43 and r = 0.4; respectively, p < 0.0001). Patients with the highest hsCRP levels (>75 percentile) had a greater body mass index (p = 0.00009) as well as truncal and android fat mass (p = 0.04 and p = 0.03, respectively) than those with the lowest levels (<25 percentile). High level of α1-AGP (>75 percentile) was associated with urinary albumin/creatinine ratio (p = 0.01) and GV indices (M-value: p = 0.02, MAG: p = 0.04).

Conclusions

Conclusions. Levels of acute-phase proteins (hsCRP and α1-AGP) increased in patients with type 2 diabetes. Levels of hsCRP were associated with fat mass; meanwhile, α1-AGP levels were associated with short-time GV in these patients. The results lend support to the notion that both obesity and enhanced GV are involved in the development of chronic low-grade inflammation associated with type 2 diabetes.

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The authors declare that there are no conflicts of interest present.