AGEs对冠心病合并糖尿病患者细胞内胆固醇外流通路的影响及作用机制(1)
[摘要] 目的 探讨AGEs对冠心病合并糖尿病患者细胞内胆固醇外流通路的影响及作用机制。 方法 选取2013年8月～2015年10月我院诊治的75例冠心病合并糖尿病的患者将其作为研究组，选取同时期在我院进行体检的健康人员75例作为对照组。研究糖基化终末产物(advanced glycosylation end products，AGEs)对冠心病合并糖尿病患者细胞内胆固醇外流通路的影响，对比两组患者的糖基化终末产物(AGEs)水平以及胆固醇外流率的大小。 结果 研究组患者AGEs水平明显高于对照组，差异有统计学意义(P<0.05)。研究组患者的胆固醇的外流率明显低于对照组，差异有统计学意义(P<0.05)。HDL-C经由ABCA1途径的胆固醇流出在对照组和研究组均与PLTP活性成正相关。 结论 冠心病合并糖尿病患者血清组织内的AGEs含量水平会大幅度上升，同时AGEs含量的积累会导致细胞内胆固醇外流通路受到阻碍，胆固醇外流率降低，因此，AGEs在冠心病合并糖尿病的发生发展中起到重要作用。
[关键词] 糖基化终末产物;冠心病;糖尿病;胆固醇外流通路
[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701(2019)14-0044-04
[Abstract] Objective To investigate the effect of AGEs on intracellular cholesterol efflux pathway in patients with coronary heart disease and diabetes mellitus and its mechanism. Methods A total of 75 patients with coronary heart disease and diabetes admitted in our hospital from August 2013 to October 2015 were enrolled as the study group. 75 healthy people who underwent physical examination in our hospital were selected as the control group. The effects of advanced glycosylation end products(AGEs) on intracellular cholesterol efflux pathway in patients with coronary heart disease and diabetes were studied. And the levels of advanced glycosylation end products (AGEs) and cholesterol efflux between the two groups were compared. Results The AGEs level in the study group was significantly higher than that in the control group， and the difference was statistically significant (P<0.05). The efflux rate of cholesterol in the study group was significantly lower than that in the control group， and the difference was statistically significant(P<0.05). The cholesterol efflux of HDL-C via the ABCA1 pathway was positively correlated with PLTP activity in both the control and study groups， respectively. Conclusion The level of AGEs in serum tissue of patients with coronary heart disease and diabetes mellitus will increase significantly. At the same time， the accumulation of AGEs will lead to the obstruction of intracellular cholesterol efflux pathway and the decrease of cholesterol efflux rate. Therefore， the AGEs play an important role in the development of coronary heart disease and diabetes.
[Key words] Advanced glycosylation end products; Coronary heart disease; Diabetes; Cholesterol efflux pathway
冠心病即冠狀动脉性心脏病，为各大医院心内科较为常见的疾病之一，是心脏病的一种。该病的发病机制是冠状动脉粥化硬化导致人体内冠状动脉堵塞或者完全闭塞，造成整个机体的血、氧供应不足，而引发的心肌功能异常甚至病变。引起慢性冠心病的因素有许多，其中主要与高血压、高血糖、高血脂等因素密切相关[1-3]。因此，众多冠心病患者均伴有糖尿病。导致冠心病发生机制的物质很多，糖基化终产物(AGEs)即其中一种。AGEs是一种与还原糖交叉相连接的异质性物质。AGEs可通过刺激炎症反应、促进动脉粥样硬化斑块形成、调节血管硬度、影响细胞内胆固醇外流通路，进而参与到冠心病的整个病理生理过程中。AGEs可通过AGEs受体或者非受体两种途径参与心肌损害的过程，为了研究其作用机制，本研究选取2013年8月～2015年10月我院诊治的75例冠心病合并糖尿病的患者进行试验研究，现报道如下。, 百拇医药(徐海鹰 钟益刚 杨俊)
[关键词] 糖基化终末产物;冠心病;糖尿病;胆固醇外流通路
[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701(2019)14-0044-04
[Abstract] Objective To investigate the effect of AGEs on intracellular cholesterol efflux pathway in patients with coronary heart disease and diabetes mellitus and its mechanism. Methods A total of 75 patients with coronary heart disease and diabetes admitted in our hospital from August 2013 to October 2015 were enrolled as the study group. 75 healthy people who underwent physical examination in our hospital were selected as the control group. The effects of advanced glycosylation end products(AGEs) on intracellular cholesterol efflux pathway in patients with coronary heart disease and diabetes were studied. And the levels of advanced glycosylation end products (AGEs) and cholesterol efflux between the two groups were compared. Results The AGEs level in the study group was significantly higher than that in the control group， and the difference was statistically significant (P<0.05). The efflux rate of cholesterol in the study group was significantly lower than that in the control group， and the difference was statistically significant(P<0.05). The cholesterol efflux of HDL-C via the ABCA1 pathway was positively correlated with PLTP activity in both the control and study groups， respectively. Conclusion The level of AGEs in serum tissue of patients with coronary heart disease and diabetes mellitus will increase significantly. At the same time， the accumulation of AGEs will lead to the obstruction of intracellular cholesterol efflux pathway and the decrease of cholesterol efflux rate. Therefore， the AGEs play an important role in the development of coronary heart disease and diabetes.
[Key words] Advanced glycosylation end products; Coronary heart disease; Diabetes; Cholesterol efflux pathway
冠心病即冠狀动脉性心脏病，为各大医院心内科较为常见的疾病之一，是心脏病的一种。该病的发病机制是冠状动脉粥化硬化导致人体内冠状动脉堵塞或者完全闭塞，造成整个机体的血、氧供应不足，而引发的心肌功能异常甚至病变。引起慢性冠心病的因素有许多，其中主要与高血压、高血糖、高血脂等因素密切相关[1-3]。因此，众多冠心病患者均伴有糖尿病。导致冠心病发生机制的物质很多，糖基化终产物(AGEs)即其中一种。AGEs是一种与还原糖交叉相连接的异质性物质。AGEs可通过刺激炎症反应、促进动脉粥样硬化斑块形成、调节血管硬度、影响细胞内胆固醇外流通路，进而参与到冠心病的整个病理生理过程中。AGEs可通过AGEs受体或者非受体两种途径参与心肌损害的过程，为了研究其作用机制，本研究选取2013年8月～2015年10月我院诊治的75例冠心病合并糖尿病的患者进行试验研究，现报道如下。, 百拇医药(徐海鹰 钟益刚 杨俊)