臨床および医療生化学

概要

The Pattern of Circulating Microparticles in Diabetes Mellitus Patients with Known Subclinical Atherosclerosis

Alexander Berezin, Alexander Kremzer, Tatyana Berezina, Yulia Martovitskaya and Olena Gromenko

Background: Accelerating atherosclerosis in Type 2 diabetes mellitus (T2DM) patients may relate with imbalance between pattern of microparticles (MPs), which frequently involved in repair of vasculature, tissue injury, inflammation and thrombosis. The aim of the study: to investigate the pattern of circulating MPs in T2DM patients with asymptomatic atherosclerosis. Methods: The study retrospectively evolved a total of 103 patients with T2DM (54 subjects without documented coronary atherosclerosis and 49 patients with angiographic evidence of asymptomatic coronary atherosclerosis) who were undergone a contrast-enhanced multispiral tomography angiography prior study entry and 35 healthy volunteers. To determine circulating biomarkers, blood samples were collected at baseline. MPs were labeled and characterized by flow cytometry. Results: There were no significant differences between healthy volunteers and T2DM patients in circulating numbers of MPs labeled as CD41a+, CD64+, CD144+, CD144+/CD31+, Annexin V+, CD144+/annexin V+, and CD144+/CD31+/ annexin V+. However, lower number of MPs with immune phenotypes CD62E+, CD105E+ and higher numbers of CD31+/annexin V+ MPs were reported in T2DM patients when compared with healthy volunteers. Therefore, we found an increased level of circulating CD41a+ MPs, CD144+/CD31+ MPs, CD31+/annexin V+ MPs, and decreased level of CD62E+ MPs in T2DM patients with asymptomatic coronary atherosclerosis in comparison with those who had no asymptomatic atherosclerosis. Using multivariate Cox regression analysis, BMI (odds ratio [OR]=1.04, P=0.001), LDL-C (OR=1.05, P=0.046), hs-CRP (OR=1.07, P=0.044), osteoprotegerin (OR=1.07, P=0.026), CD62E+ MPs (OR=1.07, P=0.001) and CD31+/annexin V+ MPs (OR=1.12, P=0.003) were determined independent predictive factors of asymptomatic atherosclerosis in T2DM patients. Conclusion: circulating levels of MP originated apoptotic endothelial cell-derived were significantly increased in diabetic patients as compared with normal subjects, but level of activated endothelial cell-derived MPs was lower than in healthy volunteers. Among T2DM patients only an increased level of CD31+/annexin V+ MPs and decreased CD62E+ MPs were significantly associated with asymptomatic atherosclerosis.