| BackgroundWith the remarkable economic development and lifestyle changes,diabetes and obesity have risen rapidly in the prevalence rate in recent years,which are global public health problems.Diabetes mellitus can cause all the vital organs of the body lesions,leading to cardiovascular events,stroke,end-stage kidney disease,blindness and other serious complications,but also leading to high disability and mortality.Cardiovascular disease is the most important cause of death in patients with diabetes.The incidence of diabetes is directly related to the prevalence of global obesity epidemic.As a part of the clinical manifestations of metabolic syndrome,abdominal obesity could aggravate the disease progression of patients with type 2 diabetes mellitus and atherosclerosis and acts as an independent risk factor for cardiovascular events.With the increasing incidence of obesity,the occurrence of atherosclerosis in obese diabetes mellitus patients increased gradually.The combination of these independent cardiovascular risk factors can greatly increase the complexity of metabolic disorders and improve the incidence of macrovascular diseases in diabetic patients,but also could lead to poor prognosis.In order to delay the development and progression of this kind of diseases,we need more comprehensive understanding of the clinical characteristics of obese diabetes patients with atherosclerosis to get more effective targeted treatment.How to provide more effective treatments and improve the prognosis of diabetic patients with obese and atherosclerosis is a current hot and difficult clinical research.Conventional treatment of diabetes mellitus includes reducing blood glucose,anti-hypertension,lipid regulation,anticoagulation and so on.The chronic high glucose state in diabetes mellitus has been shown to affect organ function primarily through oxidative stress,inflammatory response,and insulin resistance,so besides the conventional treatment,treatment targeted for these possible pathophysiological changes is progressively applied clinically.In recent years,a large number of studies have found that these pathophysiological changes may be the common pathogenesis of diabetes,obesity and atherosclerosis.So similar treatments is expected to be used in diabetic patients with atherosclerosis and obesity.ObjectiveThe study aims to investigate the clinical characters of oxidative stress and inflammation reactions in the obese and normal-weight patients with atherosclerosis and the influence of the Safflower Yellow Injection on them in these two groups in order to evaluate the clinical application value of Safflower Yellow to controloxidative stress and inflammation reactions in diabetic patients with atherosclerosis and obesity.Methods1.Subjects grouping:The study enrolled 117 diabetic subjects(45-76 years old)with carotid or lower extremity atherosclerot;ic plaque from inpatients and outpatients in Qilu Hospital,Shandong University from October 1st,2015 to July 1st,2016.All the patients(n = 117)were randomly assigned to normal-weight group(BMI<24)(A group,n=60)and obese group(BMI>28)(B group,n?57).2.Treatment and data collecting:After better blood glucose and lipid control,all the patients were given the Safflower Yellow Injection treatment(100mg Safflower Yellow dissolved in 250mL 0.9%sodium chloride,once per day for 14 days).The collected data includes gender,age,BMI,height,weight,waist circumference,history of smoking and drinking,common chronic history,history of infectious diseases,history of surgery and trauma,medication history,family history,women asked menstruation and marriage history,treatment and so on.Levels of ox-LDL,8-iso-PGF2?,GPxI,sICAM-1,IL-6,IL-10 and TNF-a were examined at baseline and post-treatment.3.Data processing:In this study the statistical analysis of the whole data is by Excel 2007 and SPSS 19.0 software.Measurement data is recorded with mean ±standard deviation(x±s),those conforming to normal distribution using t test and the rest transferring formation of log when compared between two groups.Data collected before and after treatment of one group were statistically settled by paired t test.P<0.05 is considered statistically significant.Results1.Before treatment of Safflower Yellow Injection,comparison of general clinical data in group A and group B implies that serum TG,sICAM-1,TNF-a and IL-6 levels have statistic significance(P<0.05).2.The data collected before and after use of Safflower Yellow Injection in group A showed that serum ox-LDL,8-iso-PGF2a,sICAM-1,IL-6,TNF-?,GPx1 and IL-10 levels were significantly different(P<0.05).3.The data collected before and after use of Safflower Yellow Injection in group B showed that serum ox-LDL,8-iso-PGF2a,sICAM-1,IL-6,TNF-?,GPx1 and IL-10 levels were different significantly(P<0.05).4.The data collected after the use of Safflower Yellow Injection for two weeks between the two groups showed that serum 8-iso-PGF2?,sICAM-1,IL-6 and TNF-a levels decreased significantly in group B and the data has statistic significance(P<0.05).Conclusions:1.Compared with normal-weight patients suffering from type 2 diabetes mellitus with atherosclerosis,the obese group show more severe conditions of oxidative stress and inflammation reactions.2.The Safflower Yellow Injection could alleviate oxidative stress and inflammation reactions in obese and normal-weight patients suffering from type 2 diabetes mellitus with atherosclerosis and may work more effectively in the obese group.3.Safflower Yellow can suppress oxidative stress and inflammation reactions,which may contribute to prevention and treatment of atherosclerosis in obese T2DM patients and delay disease progression and then reduce the incidence of cardiovascular events.The Safflower Yellow Injection seems to be an clinical effective drug to control conditions of oxidative stress and inflammation reactions in patients suffering from type 2 diabetes mellitus with atherosclerosis and obesity. |
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