| Objective:To study the levels of serum lipopolysaccharide (LPS) in patients with type 2 diabetes mellitus and its association with development and regression of macrovascular atherosclerosis in the patients at one year of follow-up.Method:Serum of eighty four patients with type 2 diabetes at one year of follow-up and 55 nondiabetic subjects were analyzed for LPS and AGI from the project of the National Eleventh Five-Year "Macrovascular complications prevention:experimental and control model in type 2 diabetes " under taken in center of The Second Affiliated Hospital of Dalian Medical University. The data collected were age, sex, history of smoking, history of high blood pressure, Fasting plasma glucose (FPG), serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1C), serum creatinine (Cr), blood urea nitrogen (BUN), serum insulin (Ins), random urine albumin (UA) at the time of enrollment and one year later. Insulin resistance index (HOMA-IR) and pancreaticβcell function index (HOMA-β) were calculated with HOMA model. Ultrasound measurement of the intima-thickness, plaque numbers, size, and echo characteristics of common carotid artery, femoral artery, iliac artery were taken by the same trained doctor. Human lipopolysaccharide/endotoxin (LPS) was measured with a commercial ELISA Kit. Advanced glycation index (AGI) was determined by a florence spectrometry.Results:1. The LgLPS of diabetic patients were higher than nondiabetic subjects (1.58±0.28 vs 1.40±0.24,t=-4.005,P<0.01).2. Subjects were divided into diabetic macrovascuiar atheroselerosis group (AS group) and non-atherosclerosis group (NAS group). At enroll-ment, baseline age (56.82±7.45 vs 44.56±7.41, t=-5.927,P<0.01), FPG (8.24±3.03 vs 6.69±1.56, t=-2.883,P<0.01) and HbA1C (8.15±2.05 vs 6.54±0.69,t=-5.320, P<0.01) of AS group were higher than NAS group. lgHOMA-β(1.65±0.36 vs 1.86±0.32, t=-5.927, P<0.05) was lower than NAS group. LPS and other research indices were showed no significant difference. There was no significant difference between AS group and NAS group after one year.3. Subjects were divided into high-LPS group, middle-LPS group and low-LPS group. At enrollment, baseline BMI (26.76±2.89 vs 24.86±2.56, t=-2.248, P<0.05) of the high-LPS group was higher than low-LPS group, FPG (6.95±1.67 vs 8.86±3.64,t=2.191, P<0.05) and age (51 48±9.46 vs 57.38±8.02,t=2.181, P<0.05) were lower than low-LPS group. LgAGI (1.77±0.08 vs 1.83±0.07,t=2.601, P<0.05) of high-LPS group was lower than middle-LPS group after one year, and HbA1C (6.74±1.20 vs 6.17±0.53, t=-2.614, P<0.05) of middle-LPS group was higher than low-LPS group. Other research indices in the three groups were showed no significant difference. The number of macrovascuiar disease in the three groups was not significantly different not only at enrollment but also one year later of the experiment (at enrollment:x2=3.393, P=0.183; one year later: x2=0.893, P=0.640).4. Subjects were divided into only high-LPS group, only high-AGI group, both LPS and AGI high group, both LPS and AGI low group and middle group. At enrollment, baseline HbA1C (7.3±1.9 vs 9.1±2.6,t=-2.104, P<0.05) of only high-LPS group was lower than both LPS and AGI low group. FPG (6.8±1.4 vs 8.5±3.2,t=-2.873, P<0.01) of only high-LPS group was lower than middle group. HbA1C (7.4±1.6 vs 9.1±2.6,t=-2.179, P<0.05) of only high-AGI group was lower than both LPS and AGI low group. After one year, FPG (6.3±1.1 vs 8.0±2.3, r=-2.825, P<0.01) and LDL-C (2.4±0.6 vs 2.9±0.6,t=-2.261, P<0.05) of only high-LPS group were lower than only high-AGI group. FPG (8.0±2.3 vs 6.5±0.7, t=2.484, P<0.05) of only high-AGI group was higher than both LPS and AGI low group, TC (5.1±1.0 vs 4.3±0.9, t=3.100, P<0.01) and LDL-C (2.9±0.6 vs 2.4±0.7, t=2.594, P<0.05) of only high-AGI group were higher than middle group. SBP (143±11 vs 125±6, t=3.332, P<0.01) and DBP (98±4 vs 82±9, t=2.328, P<0.05) of both LPS and AGI high group were higher than both LPS and AGI low group, DBP (98±4 vs 83±9, t=2.282, P<0.05) and TC (6.0±0.5 vs 4.3±0.9,t=2.667, P<0.05) of both LPS and AGI high group were higher than middle group. Other research indices in the five groups were showed no significant difference.The number of macrovascular disease in the five groups was not significantly different not only at enrollment but also one year later of the experiment (at enrollment:x2= 4.344, P=0.361; one year later:x2= 2.253, P=0.689).5. LPS was positively correlated with systolic blood pressure after one year (r=0.282, P=0.009). The correlation between LPS with other research indices was not significant.6. The correlation between LPS with the change of carotid artery, the femoral artery, common iliac artery intima-media thickness was not signi-ficant.7. The correlation between LPS with diabetic macrovascular athero-sclerosis was not significant.8. AGI was positively correlated with smoking, Cr and BUN. The correlation between AGI with other research indices was not significant.Conclusion:LPS levels in diabetic patients were higher than nondiabetic subjects. LPS may be associated with arteriolosclerosis and development of hypertension. It is still to be needed to study the role of LPS in the development of macrovascular atherosclerosis in type 2 diabetes.
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