阿卡波糖对冠心病合并糖耐量受损患者YKL-40和肠道菌群的影响

doi:10.6040/j.issn.1671-7554.0.2019.513

摘要/Abstract

摘要： 目的探讨阿卡波糖在冠心病合并糖耐量受损(IGT)患者中对于炎症因子YKL-40和肠道菌群的作用。方法选取冠心病合并IGT患者57例,随机分为对照组(A组,n=27)和阿卡波糖300 mg/d干预组(B组,n=30),分别在基线水平和24周实验结束时进行体质指标评估、空腹血糖(FBG)、餐后2 h血糖(PBG)、血清胰岛素(FINS), 血脂、糖化血红蛋白(HbA1C)和血清YKL-40测定;应用实时荧光定量PCR检测粪便中双歧杆菌和乳酸菌的含量。结果 A组和B组基线资料差异无统计学意义(P>0.05),Pearson相关结果分析表明,双歧杆菌和乳酸菌水平与YKL-40呈负相关。24周研究终点时B组YKL-40、FBG、PBG、HbA1c、胰岛素抵抗指数HOMA-IR等指标较A组显著降低(P<0.05);粪便双歧杆菌和乳酸菌含量显著增加(P<0.05)。结论应用300 mg/d阿卡波糖治疗24周后,冠心病合并IGT患者血糖得到改善, YKL-40显著下降, 肠道内有益细菌菌群数量增加。

关键词: 阿卡波糖, 冠状动脉粥样硬化性心脏病, 糖耐量受损, YKL-40, 肠道细菌

Abstract: Objective To investigate the effects of alpha-glucosidase inhibitor, acarbose, on YKL-40 and gut bacteria in coronary heart disease(CHD)patients with impaired glucose tolerance(IGT). Methods A total of 57 CHD patients with IGT were randomly divided into the control group(group A, n=27)and 300 mg/d acarbose intervention group(group B, n=30). At the baseline and 24-week end point, anthropometrical parameters, fast blood glucose(FBG), 2 h postprandial blood glucose(PBG), serum fast insulin(FINS), lipid profile, HbA1c and serum YKL-40 were measured. The quantification of fecal Bifidobacterium and Lactobacillus faecalis were detected with RT-PCR. Results There were no significant differences between the two groups in terms of the physical and hematological parameters at baseline. Pearson correlation analysis showed that levels of Bifidobacterium and Lactobacillus were negatively correlated with YKL-40. After 24-week acarbose(300 mg/d)treatment, the levels of YKL-40, FBG, PBG, HbA1c and HOMA-IR significantly decreased in group B(P<0.05), while the levels of Bifidobacterium and Lactobacillus significantly increased in group B(P<0.05). Conclusion After 24-week treatment with 300 mg/d acarbose, CHD patients with IGT have improved glucose metabolism, decreased YKL-40 level, but increased number of beneficial gut microbiota.

Key words: Acarbose, Coronary heart disease, Impaired glucose tolerance, YKL-40, Gut bacteria

中图分类号:

R574

娄福臣,刘性祥,马国云,庄向华. 阿卡波糖对冠心病合并糖耐量受损患者YKL-40和肠道菌群的影响[J]. 山东大学学报 (医学版), 2019, 57(7): 86-91.

LOU Fuchen, LIU Xingxiang, MA Guoyun, ZHUANG Xianghua. Effects of acarbose on YKL-40 and gut bacteria in coronary heart disease patients with impaired glucose tolerance[J]. Journal of Shandong University (Health Sciences), 2019, 57(7): 86-91.

参考文献

[1] Lathief S, Inzucchi SE. Approach to diabetes management in patients with CVD [J]. Trends Cardiovasc Med, 2016, 26(2): 165-179.
[2] Popp Switzer M, Elhanafi S, San Juan ZT. Change in daily ambulatory activity and cardiovascular events in people with impaired glucose tolerance [J]. Curr Cardiol Rep, 2015, 17(3): 562. doi: 10.1007/s11886-015-0562-3.
[3] Housley WJ, Pitt D, Hafler DA. Biomarkers in multiple sclerosis [J]. Clin Immunol, 2015, 161(1): 51-58.
[4] Shao R. YKL-40 acts as an angiogenic factor to promote tumor angiogenesis [J]. Front Physiol, 2013, 4: 122. doi: 10.3389/fphys.2013.00122.
[5] Deng X, Liu Y, Luo M, et al. Circulating miRNA-24 and its target?YKL-40?as potential biomarkers in patients with coronary heart disease and type 2 diabetes mellitus [J]. Oncotarget, 2017, 8(38): 63038-63046.
[6] Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation [J]. Diabet Med, 1998, 15(7): 539-553.
[7] Katakami N. Mechanism of development of atherosclerosis and cardiovascular disease in diabetes mellitus [J]. J Atheroscler Thromb, 2018, 25(1): 27-39.
[8] 陆衡, 刘延国, 李曙光,等. YKL-40对卵巢癌SKOV-3细胞迁移能力的影响[J]. 山东大学学报(医学版), 2017, 55(1): 33-38. LU Heng, LIU Yanguo, LI Shuguang, et al. Regulation of epithelial ovarian carcinoma SKOV-3 cell migration by YKL-40 [J]. Journal of Shandong University(Health Sciences), 2017, 55(1): 33-38.
[9] Kjaergaard AD, Johansen JS, Bojesen SE, et al. Role of inflammatory marker YKL-40 in the diagnosis, prognosis and cause of cardiovascular and liver diseases [J]. Crit Rev Clin Lab Sci, 2016, 53(6): 396-408.
[10] Yang L, Dong H, Lu H, et al. Serum YKL-40 predicts long-term outcome in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction [J]. Medicine(Baltimore), 2019, 98(12): e14920. doi: 10.1097/MD.0000000000-014920.
[11] Naka KK, Papathanassiou K, Bechlioulis A, et al. Association of vascular indices with novel circulating biomarkers as prognostic factors for cardiovascular complications in patients with type 2 diabetes mellitus [J]. Clin Biochem, 2018, 53: 31-37. doi: 10.1016/j.clinbiochem.2017.12.010.
[12] Çetin M, Erdo(ˇoverg)an T, Kır T, et al. Elevated serum YKL40 level is a predictor of MACE during the long-term follow up in hypertensive patients [J]. Clin Exp Hypertens, 2019, 16: 1-4. doi: 10.1080/10641963.2019.1632342.
[13] Kulkarni NB, Ganu MU, Godbole SG, et al. Assessment of potential biomarkers of atherosclerosis in Indian patients with type 2 diabetes mellitus [J]. Indian J Med Res, 2018, 147(2): 169-176.
[14] Sun L, Liu JY, Li LR. Serum YKL-40 levels are associated with type 2 diabetes mellitus in patients with obstructive sleep apnea syndrome [J]. Genet Mol Res, 2015, 14(3): 8919-8925.
[15] Thomsen SB, Rathcke CN, Skaaby T, et al. The Association between genetic variations of CHI3L1, levels of the encoded glycoprotein YKL-40 and the lipid profile in a Danish population [J]. PLoS One, 2012, 7(10): e47094. doi: 10.1371/journal.pone.0047094.
[16] Li XZ, Zhao SC, Cai XL, et al. Differences in expression of YKL-40 and TLR4 in nasal sinus mucosa of chronic sinusitis patients with and without nasal polyps [J]. J Biol Regul Homeost Agents, 2018, 32(3): 537-543.
[17] Holman RR, Coleman RL, Chan JCN, et al. Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance(ACE): a randomised, double-blind, placebo-controlled trial [J]. Lancet Diabetes Endocrinol, 2017, 5(11): 877-886.
[18] Sheu WH, Rosman A, Mithal A, et al. Addressing the burden of type 2 diabetes and cardiovascular disease through the management of postprandial hyperglycaemia: an Asian-Pacific perspective and expert recommendations [J]. Diabetes Res Clin Pract, 2011, 92(3): 312-321.
[19] Chiasson JL, Josse RG, Gomis R, et al. Acarbose for prevention of type 2 diabetes mellitus: the STOPNIDDM randomised trial [J]. Lancet, 2002, 359(9323): 2072-2077.
[20] Mertes G. Safety and efficacy of acarbose in the treatment of Type 2 Diabetes: data from 5-year surveillance study [J]. Diabetes Res Clin Pract, 2001, 52(3): 193-204.
[21] Yu MH, Lin MC, Huang CN, et al. Acarbose inhibits the proliferation and migration of vascular smooth muscle cells via targeting Ras signaling [J]. Vascul Pharmacol, 2018, 103-105: 8-15. doi: 10.1016/j.vph.2018.02.001.
[22] Gu Y, Wang X, Li J, et al. Analyses of gut microbiota and plasma bile acids enable stratification of patients for antidiabetic treatment [J]. Nat Commun, 2017, 8(1): 1785. doi: 10.1038/s41467-017-01682-2.
[23] Wang J, Zheng J, Shi W, et al. Dysbiosis of maternal and neonatal microbiota associated with gestational diabetes mellitus [J]. Gut, 2018, 67(9): 1614-1625.
[24] So D, Whelan K, Rossi M, et al. Dietary fiber intervention on gut microbiota composition in healthy adults: a systematic review and meta-analysis [J]. Am J Clin Nutr, 2018, 107(6): 965-983.
[25] Zhang X, Fang Z, Zhang C, et al. Effects of acarbose on the gut microbiota of prediabetic patients: a randomized, double-blind, controlled crossover trial [J]. Diabetes Ther, 2017, 8(2): 293-307.
[26] Kikuchi K, Ben Othman M, Sakamoto K. Sterilized bifidobacteria suppressed fat accumulation and blood glucose level [J]. Biochem Biophys Res Commun, 2018, 501(4): 1041-1047.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed