| Objective: Macrovascular disease,one of the main reasons of death, effects on the survival and quality of life in type 2 diabetes patients seriously. The basic pathological change of macrovasular disease is atherosclerosis (atherosclerosis, AS). Abnormal lipid metabolism, especially the high level of free fatty acids has a close realationship with macrovascular disease. Adipocyte fatty acid binding protein (adipocyte fatty acid binding proteins, AFABP) as the chaperone protein of free fatty acid (free fatty acids,FFA), combines saturated and unsaturated long-chain fatty acids in vivo reversibly and transports FFA to the endoplasmic reticulum, mitochondria, peroxide proliferation enzyme complex body, nucleus et al, in order to beβ-oxidized further,meanwhile, AFABP overexpression in macrophages can promote triglycerides and cholesterol deposition, transform macrophages into foam cells and promote the formation of AS. We classify the type 2 diabetic patients by the severity of macrovascular disease and measure their serum FFA, AFABP contents and general biochemical parameters of blood in the normals, the no-vascular disease of the type 2 diabetic patients and have-vascular disease of the type 2 diabetes patients, aiming at defining the relationship among the serum free fatty acid profiles, AFABP content and the macrovascular disease in the type 2 diabetes.Methods: 173 in-ward patients with type 2 diabetes in the Second Hospital of Hebei Medical University from August 2008 to August 2009, 100 males and 73 females, 26-93 years old, mean age is 56.7±10.9 years. All of them are grouped according to the number of macrovascular complications: Group A: type 2 diabetic patients without macrovascular disease, 36 cases (male 24, 12 females), mean age is 55.7±5.9 years; Group B: having one macrovascular disease, 59 cases (male 36, female 23), mean age is 56.7±9.7 years; Group C: having two large vascular diseases,58 cases (male 31, female 27), mean age is 58.3±7.4 years; Group D: more than three major vascular diseases, 20 cases (9 males and 11 females), mean age is 59.8±8.9 years old; group N:the normals for health without diabetes hereditary, 41 cases ( male 25, female 16), 39-76 years old, mean age is 54.2±7.4 years. All subjects are detected,including fatty acids by Gas chromatography external standard method, AFABP by ELISA method, glycated hemoglobin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C) and other clinical indicators, collected of patient's age, body mass index and percentage of body fat (PBF), systolic blood pressure (SBP), diastolic blood pressure (DBP) et al. All data are used by SPSS13.0 Statistical Package for the treatment.Results:1 Compared with the normal group: total fatty acids (total fatty acid, TFA), saturated fatty acids (saturated fatty acid, SFA), polyunsaturated fatty acids (polyunsaturated fatty acids, PUFA) are significantly high in type 2 diabetes (TFA: P<0.01, SFA: P<0.05, PUFA: P<0.01); palmitic acid (C16:0), stearic acid (C18:0), oleic acid (C18:1), linoleic acid(C18:2), isoselachoceric acid(C24:0)level elevate significantly(C16:0, C18:0 P<0.01, C18:1 P<0.05, C18:2 P<0.01, C24:0 P<0.05);docosahexaenoic acid(C22:6) significantly decreases P<0.01. Serum AFABP content in diabetic group increases significantly P<0.01. Other general clinical information such as BMI, PBF, blood pressure , TG, TC, LDL-C also increase in diabetic group P<0.01.2 Comparation of no-vascular disease group and have-vascular disease group: TFA, SFA and monounsaturated fatty acids(monounsaturated fatty acid, MUFA) increase significantly in have-vascular disease group(TFA and MUFA: P<0.05, SFA:P<0.01). C16:0, C18:0, C18:1 are significantly high (C16:0, C18: 0 P<0.05, C18:1 P<0.01). AFABP content in vascular disease group is also high P<0.01.3 Comparison among the vascular disease group: TFA, MUFA, SFA and C16:0, C18:0, C18:1 in A, B, C, D groups increase significantly with the severity of vascular disease. AFABP content in B, C, D group are higher than group A(P<0.05). Comparison of other clinical indicators: PBF: group B, C, D is significantly higher then group A (P<0.01). SBP: group C and D is significantly higher then group A and group B (P<0.01). Comparison of serum lipids: LDL in group C is higher than group A (P<0.05). TC in group C and group D decrease significantly(P<0.01).4 Relationship: TFA is correlated positively with AFABP, TG, TC, LDL,SBP and DBP, their correlation coefficients are 0.685, P <0.01; 0.335, P <0.01; 0.205, P<0.05; 0.260,P<0.05;0.665, P<0.01; 0.598, P<0.01 seperately. AFABP content is positively correlatedn with TFA, TC, LDL, SBP and DBP:correlation coefficients are 0.685, P<0.01; 0.217, P<0.05; 0.303, P<0.01; 0.308, P<0.01; 0.286, P<0.01 seperately.Conclusion:1 In type 2 diabetes, TFA,SFA, PUFA, C16:0, C18:0, C18:1, C18:2, C24:0 increase and C22:6 decrease.. Knowing the change of free fatty acid profiles, we can improve the lipid metabolism disorder by adjusting the dietary habits or intake some fatty acids for good consciously before TC,TG abnormals..2 AFBAP, positively correlated with TC, LDL-C,is high in type 2 diabetic patients and the have-vascular disease groups. AFBAP play an important role in fatty acid metabolism not only, but also advance atherosclerosis. As a bridge of fatty acid metabolism and inflammatory response, AFABP is an early predictive inditector of lipid abnomal and macrovascular disease diagnosis in type 2 diabetes. .3 TFA, SFA, MUFA and C16:0, C18:0, C18:1 contents have a relationship with macrovasular disease in type 2 diabetic patients and increase successively with the severity of vascular disease.Understanding the change of free fatty acids' composition, it benefits diabetic patients a lot for preventing and treating macrovascular complication.. |
PDF Full Text Request