The contributions of fasting and postprandial blood glucose increments to oxidative stress and inflammation in dyslipidemic type 2 diabetic patients with stable ischemic heart disease

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• 作者：Boris Djindjic^a ; ^b ; ^{boris_dj@medfak.ni.ac.rs} ; Tomislav Kostic^b ; Zoran Radovanovic^c ; Natasa Djindjic^d ; Marko Lazovic^b ; Misko Zivic^d ; Zoran Perisic^b ; Nebojsa Krstic^b
• 关键词：Diabetes mellitus ; Oxidative stress ; Inflammation ; Adhesive molecules ; Ischemic heart disease ; Fasting hyperglycemia ; Postprandial hyperglycemia
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：611-616
• 全文大小：728 K
• 卷排序：227

文摘

Contributions of fasting and postprandial blood glucose increments on level of inflammation and oxidative stress biomarkers in patients with stable ischemic heart disease (IHD) and diabetes mellitus type 2 (T2DM) was evaluated.MethodologyNinety T2DM patients (60 with IHD and 30 without IHD) treated with metformin and/or sulphonylurea were enrolled in cross-sectional nested case–control clinical study. The areas under the six-point daily glucose curve above the fasting glucose concentrations (AUCpp) and over 5.5 mmol/L (AUCbg) were calculated to determine postprandial (AUCpp) and fasting (AUCbg-AUCpp) glucose increments. Malondialdehyde (MDA), protein carbonyl group (PCO), fibrinogen, C-reactive protein (hsCRP), leukocyte count and adhesion molecules ICAM-1 and VCAM-1 were determined.ResultsAUCbg-AUCpp 58.2 (95%CI 40.6–75.8) was higher in IHD group compared to non-IHD 36.9 (95%CI 23.5–50.2) mmol*h/L. They had significantly higher ICAM-1 (mean ± SD) 72.70 ± 30.6 vs. 60.22 ± 22.6 ng/mL and MDA 16.47 ± 4.5 vs. 13.42 ± 4.01 μmol/g plasma proteins, but similar PCO, VCAM-1, fibrinogen, hsCRP concentration and leukocyte count. AUCpp positively correlated with MDA (r = 0.45) and ICAM-1 (r = 0.32) in the presence of IHD, and VCAM-1 (r = 0.44) in the absence of IHD. AUCbg-AUCpp positively correlated with PCO (r = 0.45) in the absence of IHD. The analysis revealed that AUCpp over turning point of 0 mmol*h/L was associated with high MDA and ICAM-1 expression in diabetics with IHD. AUCbg-AUCpp over 30 mmol*h/L leads to high oxidative protein modification in diabetics without IHD.ConclusionIn T2DM patients with stable IHD, AUCpp at any point, significantly contributes to increasing of MDA and ICAM-1 expression. Fasting blood glucose increment showed significant correlation with carbonyl content in diabetics without IHD.