老年学と老年医学の研究

概要

Immune Phenotype of Circulating Endothelial-derived Microparticlesin Elderly Patients with Metabolic Syndrome and Diabetes Mellitus

Alexander E. Berezin, Alexander A. Kremzer, Tatyana A Samura, Tatyana A Berezina

Type two diabetes mellitus (T2DM) remains a leading contributor to cardiovascular mortality worldwide. This study was conducted to investigate the pattern of circulating EMPs in adults and elderly patients with T2DM and metabolic syndrome (MetS). Methods: The study retrospectively evolved 76 elderly patients (43 subjects with T2DM and 33 patients with MetS) and 101 adult subjects (54 subjects with T2DM and 47 patients with MetS) with metabolic disorders. All the patients have given written informed consent for participation in the study. Biomarkers were measured at baseline of the study. Results: There is a significant difference between adult subjects and elderly patients enrolled in the study regarding CD31+/annexin V+ EMPs to CD62E+ EMPs ratio and CD144+/CD31+/annexin V+ EMPs to CD62E+ EMPs ratio, which reflects impaired phenotype of EMPs. Therefore, CD31+/annexin V+ EMPs to CD62E+ EMPs ratio and CD144+/CD31+/annexin V+ EMPs to CD62E+ EMPs ratio were found to be higher in the T2DM elderly patients compared to MetS elderly patients. Using multivariate linear regression analyses, independent impact of T2DM (r=0.40, P=0.003), OPG (r=0.37, P=0.001), hs-CRP (r=0.347, P=0.001), and adiponectin (r=0.33, P=0.001) on increased CD31+/annexin V+ to CD62E+ ratio of EMPs was determined. Therefore, T2DM (r=0.42, P=0.003), OPG (r=0.34, P=0.001), and adiponectin (r=0.32, P=0.001) predicted increased CD144+/CD31+/annexin V+ EMPs to CD62E+ EMPs ratio.Using C-statistics for Models with T2DM, and circulating biomarkers (hs-CRP, OPG and adiponectin) as Continuous Variables we found that adding of combination of inflammatory biomarkers (hs-CRP, OPG and adiponectin) to the based model (T2DM) improved the relative IDI by 12.6% for increased CD31+/annexin V+ EMPs to CD62E+ EMPs ratio and by 9.1% for increased CD144+/CD31+/annexin V+ EMPs to CD62E+ EMPs ratio. In conclusion, we found that patients with T2DM and MetS may distinguish predominantly appeared phenotypes of circulating EMPs associated with pro-inflammatory cytokine over production. Elevated CD31+/annexin V+ EMPs to CD62E+ EMPs ratio and CD144+/CD31+/annexin V+ to CD62E+ EMPs ratio are indicator of impaired immune phenotype of EMPs, which allows determining pattern of EMPs in dysmetabolic disorder patients.