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目的:观测2型糖尿病(T2DM)患者血浆氨甲酰化低密度脂蛋白(cLDL)水平以及髓过氧化物酶(MPO)的参与作用。方法:随机入选健康体检者165名(NC),新诊断的T2DM患者190例,选取其中80例T2DM患者给予噻唑烷二酮类(吡格列酮+二甲双胍)或磺脲类(格列美脲+二甲双胍)药物治疗药物治疗6个月,采用ELISA检测各组受试者血浆cLDL及MPO水平,用于观测MPO水平变化对LDL氨甲酰化的影响。结果:T2DM组血浆cLDL(P<0.05)及MPO(P<0.01)均高于NC组,且T2DM组cLDL与MPO显著相关(r=0.45,P<0.05),MPO为cLDL独立影响因素(P<0.01)。吡格列酮可显著降低患者血浆MPO(P<0.05)及cLDL(P<0.01),且cLDL的降低(11.5%)与血浆MPO的下降(13.4%)呈正相关(r=0.43,P<0.01),而格列美脲对血浆cLDL及MPO均无明显作用。结论:MPO介导无肾功能不全T2DM患者LDL非尿素依赖性的氨甲酰化修饰。
Objective: To observe the plasma level of carbamylated low density lipoprotein (cLDL) and the involvement of myeloperoxidase (MPO) in type 2 diabetes mellitus (T2DM). METHODS: A total of 165 healthy subjects (NC) were randomly enrolled and 190 newly diagnosed T2DM patients were enrolled. Among them, 80 patients with T2DM were given thiazolidinediones (pioglitazone + metformin) or sulfonylureas (glimepiride + metformin) Drug therapy for 6 months, the plasma levels of cLDL and MPO in each group were detected by ELISA, and the effect of MPO level on the carbamylation of LDL was observed. Results: The levels of plasma cLDL (P <0.05) and MPO (P <0.01) in T2DM group were significantly higher than those in NC group. The cLDL was significantly correlated with MPO (r = 0.45, P < <0.01). Pioglitazone significantly decreased plasma MPO (P <0.05) and cLDL (P <0.01), and decreased cLDL (11.5%) and plasma MPO decreased (13.4%) (r = 0.43, P <0.01) Glimepiride had no significant effect on plasma cLDL and MPO. CONCLUSION: MPO mediates non-urea-dependent carbamylation of LDL in patients with T2DM without renal insufficiency.