The Relationship Between Serum 3-carboxy-4-methyl-5-propyl-2-furanpropanoic Acid(CMPF) Levels And Glucolipid Metabolism And Renal Function In Diabetics

Objective Previous studies have found that 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid(CMPF)was associated with diabetes.This study aimed to investigate the relationship between abnormal increased CMPF levels and diabetes.1.To detect serum CMPF levels in pregnent women with different glucose metbolism and to investigate the relationship between abnormal increased CMPF levels and glycolipid metabolism and islet function in gestational diabetes mellitus(GDM).2.To detect serum CMPF levels in T2 DM and to investigate the relationship between CMPF levels and glycolipid metabolism and islet function in T2 DM.3.To investigate the relationship between serum CMPF levels and various biochemical criterions such as renal function in T2 DM.Methods 1.We recruited 828 pregnant women,and all of them underwent an oral glucose tolerance test(OGTT).We screened out 141 GDM patients and 230 pregnant women with normal glucose tolerance as controls.The serum CMPF concentration in participants was measured,and the relationship between the serum CMPF concentration and various parameters and biochemical indices was analyzed.2.A total of 453 T2 DM patients with poorly glycemic control for therapy in the endocrinology department of Shanghai fengxian district central hospital from September 2015 to August 2017 were included in this study.And all of them were divided into three groups according to CMPF concentration.The islet beta cells function was represented by C peptide correlation index and the data of all patients were analyzed.3.A total of 417 T2 DM patients with poorly glycemic control for therapy in the endocrinology department of Shanghai fengxian district central hospital from September 2015 to August 2017 were included in this study.And all of them were divided into four groups according to e GFR levels,and the data of all patients were analyzed.Results 1.Compared with the serum levels in pregnant women with normal glucose tolerance,GDM patients exhibited markedly higher serum CMPF levels.The serum CMPF concentration showed an independent positive correlation with the blood glucose levels,glycated hemoglobin A1c(Hb A1c),and the area under the glucose-time curve from the 2-h OGTT(AUC for glucose).Moreover,the CMPF concentration was independently negatively correlated with insulin secretion.However,CMPF was not significantly associated with lipid metabolism.2.With the increase of circulating CMPF levels,secretion of fasting and postprandial C-peptide were gradually reduced in T2 DM patients.Bivariate correlation analyses exhibited independent negative correlations between CMPF and FC-P(-0.272,P<0.001),0.5h C-P(0.5-hour postprandial C-peptide)(r=-0.240,P<0.001),2h C-P(two-hour postprandial C-peptide)(r=-0.208,P<0.001),AUC for C-P(area under the C-peptide–time curve from the 2-h OGTT)(r=-0.233,P<0.001),Δ0.5h C-P(r=-0.210,P<0.001),Δ2h C-P(r=-0.133,P<0.001),Δ0.5h C-P/PG(r=-0.208,P<0.001),Δ2h C-P/PG(r=-0.161,P=0.005).A multivariate linear regression analysis showed that serum CMPF was negatively correlated with 0.5h C-P(β=-57.47±17.46,P=0.001)after adjusting for age,BMI,AST,ALT,e GFR.3.In T2 DM patients,there was no significant difference in serum CMPF levels in patients with normal renal function and high filtration,the logistic regression analysis revealed that CMPF was not an independent correlation factor of e GFR.The serum CMPF level was significantly higher in patients with mild renal impairment than those with normal renal function,the logistic regression analysis revealed that CMPF was an independent correlation factor of e GFR.The serum CMPF level was lower than that of normal renal function,the logistic regression analysis revealed that CMPF,duration of diabetes and blood pressure were independent correlation factors of e GFR.Conclusions 1.Elevated serum CMPF levels are detrimental to the development of hyperglycemia and islet β-cell functional failure in patients with GDM,which may promote the development of GDM.2.Increasing circulating CMPF levels may be a risk factor for progressive impairment of islet beta cell dysfunction in patients with T2 DM.3.CMPF may induce or aggravate renal impairment in patients with T2 DM,but there may be more complex integrative effects in patients with longer duration and higher blood pressure.