罗格列酮对2型糖尿病患者外周血单核细胞CD36表达的影响

目的:观察2型糖尿病患者外周血单核细胞CD36的表达及罗格列酮对其表达的影响,探讨其可能的作用机制。方法:采用流式细胞仪测定2型糖尿病患者外周血单核细胞CD36的表达,并观察罗格列酮治疗后的变化；分析CD36与2型糖尿病各临床指标间的关系。结果:2型糖尿病组患者单核细胞CD36表达明显高于正常对照组(745.9±281.3 vs 406.3±80.2,P<0.01)；动脉粥样硬化组CD36表达明显高于无动脉粥样硬化组(878.2±296.1 vs 584.2±148.3,P<0.01)。罗格列酮治疗后,患者单核细胞CD36表达、空腹血糖(FBG)、餐后血糖(PBG)、HbA1c、空腹胰岛素(FIN)、餐后胰岛素(PIN)、胰岛素抵抗程度(HOMA-IR)均降低,与治疗前、安慰剂组均有统计学差异(P<0.05或P<0.01)。糖尿病患者单核细胞CD36表达与FBG(r=0.55,P<0.05)、HbA1c(r=0.62,P<0.01)、HOMA-IR(r=0.64,P<0.01)正相关,与PBG、FIN、PIN无明显相关。结论:罗格列酮可能通过有效控制血糖、降低胰岛素抵抗等途径来降低2型糖尿病患者外周血单核细胞CD36的表达。

Effect of rosiglitazone on expression of CD36 in peripheral monocytes in patients with Type 2 diabetes

Objective:To observe the expression of CD36 in peripheral monocytes in patients with Type 2 diabetes, and to study the influence of rosiglitazone on CD36 expression and the related the mechanism. Methods: The expression of CD36 in the peripheral monocytes of patients with Type 2 diabetes was measured by flow cytometry before and after rosiglitazone treatment; the correlation between monocytes CD36 expression and metabolic index was analyzed. Results: Flow cytometry showed that the mean fluorescence intensity (MFI ) of monocyte CD36 in Type 2 diabetes was significantly higher than that in the healthy controls(745.9±281.3 vs 406.3±80.2,P<0.01). CD36 MFI in patients with Type 2 diabetes atherosclerosis was significantly higher than that in patients with Type 2 diabetes non-atherosclerosis(878.2±296.1 vs 584.2±148.3,P<0.01). Besides, we also found that CD36 expression, fasting blood glucose(FBG), post-prandial blood glucose(PBG), hemoglobin A1c(HbA1c), FIN, PIN, and HOMA-IR were all significantly decreased after rosiglitazone intervention compared with those before rosiglitazone intervetion and placebo group(P<0.05 or P<0.01). There was a positive correlation between monocyte CD36 expression with FBG(r=0.55,P<0.05), HbA1c(r=0.62,P<0.01), and HOMA-IR(r=0.64,P<0.01); but the expression was not correlated with PBG, FIN, or PIN. Conclusion: The increased expression of CD36 in monocytes of patients with Type 2 diabetes may be one of the mechanisms for accelerated atherosclerosis in diabetic patients. Rosiglitazone can decrease CD36 expression in monocytes through effectively controlling the blood glucose and decreasing insulin resistance.