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  

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

作　　者：吴佳易[1] 周珊珊[1] 沈洁[2] 谢翠华[2] 郭志刚[1] 

机构地区：[1]南方医科大学南方医院心血管内科,广州510515 [2]南方医科大学南方医院内分泌科

出　　处：《解放军医学杂志》2008年第5期537-539,共3页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金(30471929);广东省自然科学基金(06024407)

摘　　要：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。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 cytorneter. 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 （NHI）L-C） [low density lipoprotein cholesterol （LDL-C） and very low density lipoprotein cholesterol （VLDL-C）3 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.

关 键 词：糖尿病 2型 脂蛋白类 HDL胆固醇 脂蛋白类 VLDL胆固醇 ATP结合匣式转运子 

分 类 号：R587.1[医药卫生—内分泌] R34-33[医药卫生—内科学]