糖尿病冠状动脉粥样硬化与外周血单个核细胞糖基化终产物受体表达的关系及他汀类药物对其影响的研究  

The relation between the receptor for advanced glycation end products in peripheral blood mononuclear cells and diabetic coronary atherosclerosis and the protective effect of statins

作　　者：王华[1] 胡铂[2] 唐兆生[1] 宗明[3] 冯波[1] 

机构地区：[1]同济大学附属东方医院内分泌科,上海200120 [2]同济大学附属东方医院心血管内科,上海200120 [3]同济大学附属东方医院检验科,上海200120

出　　处：《中国糖尿病杂志》2014年第5期412-416,共5页Chinese Journal of Diabetes

基　　金：上海市卫生局青年基金项目(20114Y116);上海市浦东新区卫生系统优秀青年医学人才计划(PWRq2012-08);973项目(2011CB504006)

摘　　要：目的观察糖尿病冠状动脉粥样硬化程度与外周血单个核细胞(PBMC)上糖基化终产物受体(RAGE)的相关性,以及他汀类药物对其的影响。方法选择行冠状动脉造影患者188例,采用RT-PCR和Western blot检测PBMC上RAGE的表达,根据糖代谢状态和他汀类药物使用情况进行分组后,与冠状动脉的病变支数和Gensini积分行相关性分析。结果与常规组比较,他汀组PBMC上RAGE mRNA表达量、RAGE蛋白水平、冠状动脉病变支数及Gensini积分均降低,差异有统计学意义。常规组中,糖尿病患者PBMC上RAGE mRNA表达量和RAGE蛋白的水平高于非糖尿病患者(P=0.020,P=0.000)。回归分析结果表明,PBMC上RAGE mRNA表达量是冠状动脉多支病变和严重程度的独立危险因素。结论 PBMC上RAGE的表达与糖尿病冠状动脉粥样硬化密切相关,而他汀类药物可能通过下调RAGE的表达而改善冠状动脉粥样硬化。Objective To investigate the relation of the mRNA and protein expression levels of the receptor for advanced glycation end products （RAGE） in peripheral blood mononuclear cells （PBMCs） with diabetic coronary atherosclerosis , and to evaluate the protective effect of statins. Methods The 188 atherosclerosis patients with or without T2DM underwent coronary arteriography were divided into two groups： statin-treated group （89 cases） and non-statin treated group （99 cases）. The severity of coronary atherosclerosis was estimated by counting the number of diseased vessels and Gensini score using coronary angiography. The mRNA and protein expression levels of RAGE in PBMCs were measured by RT-PCR and Western blot. Results There were significant decreases in the RAGE mRNA level, RAGE protein level, the number of diseased coronary arteries , and Gensini score in the statin treated group as compared with the non-statin treated group. The RAGE mRNA and protein level （P= 0. 020, P〈 0. 000） were higher in the diabetes patients than in the non-diabetes patients in the non-statin treated group. The regression analysis indicated that the RAGE mRNA level in PBMCs was an independent risk factor of the severity of coronary atherosclerosis. Conclusion The RAGE level in PBMC is closely related to the diabetic coronary atherosclerosis. The effect of statins on coronary atherosclerosis may appeare partly byreducing the RAGE expression.

关 键 词：糖尿病 动脉粥样硬化 糖基化终产物受体 他汀 

分 类 号：R587.2[医药卫生—内分泌] R543.3[医药卫生—内科学]