ABSTRACT
Objective To observe the influence of glucose fluctuation on paraoxonase-3(PON3) and apoprotein A1(ApoA1) in T2DM patients with coronary heart disease (CHD) . Methods A total of 260 subjects were enrolled in this study and dividied into three groups :T2DM patients with CHD (T2DM +CHD group ,n=100) ,T2DM without CHD (T2DM group ,n=80) and healthy subjects(NC group ,n=80) .The serum PON3 and ApoA1 levels were measured and compared in all the three groups .The 72 h dynamic glucose monitoring (CGMS ) was adopted in T2DM + CHD group ,then according to the MAGE levels ,T2DM+ CHD group was subdivided intotertiles :the lowest tertile subgroup (2.43～3.44 mmol/L ,n=31) ,the middle tertile subgroup (3.45～4.46 mmol/L ,n=39) and the highest tertile subgroup (4.47～5.45 mmol/L ,n= 30) .Influencing factors for PON3 and ApoA1 were analyzed by multivariate linear regression analysis . Results (1)The SBP ,DBP ,FPG ,2 hPG ,HbA1c ,FIns ,ApoB ,BUN ,HOMA-IR , ApoA1 and number of smokers were higher in T2DM + CHD group than in NC group .FPG ,2 hPG ,HbA1c ,FIns and HOMA-IR were higher in T2DM+ CHD group than in T2DM group(P<0.05 or P<0.01) .LDL-C ,Lp-a and hsC-RP were higher ,and the PON3 were lower in T2DM +CHD group than in T2DM group and NC group (P< 0.05 or P< 0.01);(2)With the increase of blood glucose fluctuation range ,the levels of PON3[(0.58 ± 0.10) vs (0.44 ± 0.07) vs (0.25 ± 0.01) ng/ml]and ApoA1 [(2.33 ± 1.04) vs (2.31 ± 0.71) vs(1.05 ± 0.48)g/L]were reduced(all P=0.000);(3)Multiple linear regression analysis showed that BMI ,hsC-RP ,HOMA-IR and MAGE were influencing factors for PON3. And HbA1c ,hsC-RP and MAGE were influencing factors for ApoA1 (P<0.05 or P<0.01) . Conclusion Serum PON3 level is lower and ApoA1 level is higher in T2DM patients with CHD .Glucose fluctuation may be only an influencing factor for ApoA1 level .
ABSTRACT
Introducción y objetivos: La enfermedad cardiovascular es la primera causa de muerte en Costa Rica, razón por la cual seplantea el estudio de nuevos factores de riesgo en una población adulta de la provincia de San José.Métodos: Este estudio evaluó las concentraciones séricas del perfil lipídico, glucosa, lipoproteína (a), apoproteínas A1, B100y otros factores de riesgo de enfermedad cardiovascular en una población de 430 adultos con edades entre los 20 y 60años del área metropolitana de San José, Costa Rica.Resultados: La prevalencia de hiperlipoproteinemia (a) (≥ 0,3 g/L), hiperapoproteinemia B (> 0,65 g/L), hipercolesterolemia(> 5,17mmol/L), intolerancia a la glucosa (5,55-6,98 mmol/L) y diabetes mellitus (≥ 6,99 mmol/L) en la población es de67,8%, 87,4%, 46,3%, 14,2% y 5,7% respectivamente, sin diferencias significativas por sexo. La prevalencia de hipertrigliceridemia(>1,69 mmol/L) en la población es de 45,3%, siendo significativamente mayor en hombres que en mujeres (53,4%vs 37,2%; p = 0,001). Un porcentaje considerable de la población estudiada con niveles elevados de lipoproteína (a) (n =313) mostró simultáneamente uno o varios parámetros del perfil lipídico y la glucosa elevados. El 52,1 % presentó colesteroltotal ≥ 5,17 mmol/L; 44,4% triglicéridos ≥ 1,69 mmol/L; 25,2% HDL-colesterol < 1,03 mmol/L; 67,4 % LDL-colesterol ≥2,58 mmol/L, 45,0 % índice de Castelli ≥ 4,5, 17,9% glucosa ≥ 5,55 mmol/L y 88,8% apoproteína B > 0,65g/L. La prevalenciade síndrome metabólico en la población en estudio y según los criterios diagnósticos establecidos por la OrganizaciónMundial de la Salud es de 4,2%, fue mayor entre el género masculino (7,3% vs 1,7%; p = 0,008)...
Introduction and objectives: Cardiovascular disease is the first death cause in Costa Rica. This investigation proposes thestudy of new risk factors in an adult population of the province of San José.Methods: This study evaluated the lipid profile, glucose and other related cardiovascular risk factors in 430 adults aged20 to 60 years, residents of the metropolitan area of San José, Costa Rica.Results: The prevalences of hyperlipoprotein (a) (≥ 0,3 g/L), hyperapoprotein B (> 0,65 g/L), hypercholesterolemia (> 5,17mmol/L), impaired glucose tolerance (5,55-6,98 mmol/L) and diabetes mellitus (≥ 6,99 mmol/L) were 67,8%, 87,4%, 46,3%, 14,2% and 5,7% respectively, without significant differences between genders. The prevalence of hypertriglyceridemia(>1, 69 mmol/L) was 45,3%, being higher among the male population (53,4% vs. 37,2%; p = 0,001). A significantpercentage of the people included in this study had simultaneously high levels of lipoprotein (a) (n =313) and high levelsof another coronary risk factors such as: high cholesterol (52,1% had levels ≥ 5,17 mmol/L); high triglycerides (44,4% hadlevels ≥ 1,69 mmol/L); low HDL-cholesterol (25,2% had levels < 1,03 mmol/L); high LDL-cholesterol (67,4% had levels ≥2,58 mmol/L), high Castelli Index (45,0% had levels ≥ 4,5) , high glucose (17,9% had levels ≥ 5,55 mmol/L) and finally highlevels of apoprotein B (88,8% had levels > 0,65 g/L). The prevalence of metabolic syndrome in the studied population,according to the World Health Organization diagnostic criteria, was 4,2%, being higher among the male group (7,3% vs.1,7%; p = 0,008)...