TRAIL Concentration and Diabetic Therapy
TRAIL Concentration and Diabetic Therapy
A total of 55 type 2 diabetic patients who met the criteria were included for the study. As there were 5 study dropouts because of the upper abdominal discomfort for metformin, 50 patients completed the study.
The clinical characteristics and biochemical results of the control subjects and diabetic patients before and after therapy are given in Table 1 . Compared with control subjects, the FBG, 2-h BG, HbA1c, total cholesterol, triglycerides and LDL-C levels in diabetic patients before treatment were significantly higher (P < 0·05) and decreased significantly after 6 months of treatment (P < 0·05). The HDL-C level in diabetic patients before treatment was significantly lower than that in control subjects (P < 0·05).
The plasma TRAIL level in patients before treatment was 64·46 pg/ml, which was significantly lower than that in control subjects (80·70 pg/ml, P < 0·001). After 6 months of treatment, TRAIL level increased markedly (75·11 pg/ml, P < 0·001), which was still lower than that in control subjects (P < 0·001) ( Table 1 ). To reveal the relationship between plasma TRAIL and age, we performed the stratification of the plasma TRAIL levels with relation to the age of patients at baseline. The results showed that the plasma TRAIL concentrations did not differ significantly among different age groups [in age ≤50 years subgroup(65·95 ± 8·37, n = 17); in 50<age ≤60 years subgroup(64·35 ± 6·44, n = 25); in age >60 year subgroup (62·75 ± 3·53, n = 13)] (P > 0·05).
FMD in patients before treatment was 3·33 ± 0·44%, which was significantly lower than that in control subjects (5·37 ± 0·51%, P < 0·001), and improved markedly after 6 months of treatment (4·40 ± 0·42%, P < 0·001), which was still lower than that in control subjects (P < 0·001) ( Table 2 ). Other parameters, such as BMI, systolic blood pressure, diastolic blood pressure, and baseline vessel and glyceryltrinitrate-induced dilation, did not differ among different groups ( Table 1 and Table 2 ).
Univariate analysis showed a correlation between plasma TRAIL and FMD (r = 0·33, P < 0·001), LDL-C (r = −0·23, P = 0·043), triglycerides (r = −0·22, P = 0·045), Lp(a) (r = −0·20, P = 0·049), FBG (r = −0·31, P < 0·001), 2-h BG (r = −0·28, P < 0·001), CRP (r = −0·32, P < 0·001), BMI (r = −0·25, P = 0·037) and mean blood pressure (r = −0·26, P = 0·013) in diabetic patients at baseline. To evaluate the association of the basal levels of various clinical variables with the basal level of plasma TRAIL in diabetic patients, multiple regression analysis was performed. In model 1, which included FMD, CRP, FBG, 2-h BG and HbA1c as independent variables, the results showed that FMD, CRP, FBG, 2-h BG and HbA1c are significant factors which are associated with plasma TRAIL levels. When HbA1c was replaced by LDL-C, triglycerides, Lp(a), BMI and mean blood pressure, these variables failed to emerge as significant independent determinants of TRAIL (models 2–6) (data not shown).
Also, correlation analysis showed that the absolute changes in TRAIL significantly correlated with the changes in FMD (P < 0·001) (Fig. 1), FBG (P < 0·001) and 2-h BG (P < 0·001) (Fig. 2), HbA1c (P < 0·001) (Fig. 3) and CRP (P < 0·001) (Fig. 4), and there was no significant correlation with other parameters in diabetic patients during the course of treatment.
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Figure 1.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in FMD before and after treatment in diabetic patients.
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Figure 2.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in plasma glucose (FBG and 2-h BG) before and after treatment in diabetic patients.
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Figure 3.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in HbA1c before and after treatment in diabetic patients.
(Enlarge Image)
Figure 4.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in CRP before and after treatment in diabetic patients.
Results
A total of 55 type 2 diabetic patients who met the criteria were included for the study. As there were 5 study dropouts because of the upper abdominal discomfort for metformin, 50 patients completed the study.
The clinical characteristics and biochemical results of the control subjects and diabetic patients before and after therapy are given in Table 1 . Compared with control subjects, the FBG, 2-h BG, HbA1c, total cholesterol, triglycerides and LDL-C levels in diabetic patients before treatment were significantly higher (P < 0·05) and decreased significantly after 6 months of treatment (P < 0·05). The HDL-C level in diabetic patients before treatment was significantly lower than that in control subjects (P < 0·05).
The plasma TRAIL level in patients before treatment was 64·46 pg/ml, which was significantly lower than that in control subjects (80·70 pg/ml, P < 0·001). After 6 months of treatment, TRAIL level increased markedly (75·11 pg/ml, P < 0·001), which was still lower than that in control subjects (P < 0·001) ( Table 1 ). To reveal the relationship between plasma TRAIL and age, we performed the stratification of the plasma TRAIL levels with relation to the age of patients at baseline. The results showed that the plasma TRAIL concentrations did not differ significantly among different age groups [in age ≤50 years subgroup(65·95 ± 8·37, n = 17); in 50<age ≤60 years subgroup(64·35 ± 6·44, n = 25); in age >60 year subgroup (62·75 ± 3·53, n = 13)] (P > 0·05).
FMD in patients before treatment was 3·33 ± 0·44%, which was significantly lower than that in control subjects (5·37 ± 0·51%, P < 0·001), and improved markedly after 6 months of treatment (4·40 ± 0·42%, P < 0·001), which was still lower than that in control subjects (P < 0·001) ( Table 2 ). Other parameters, such as BMI, systolic blood pressure, diastolic blood pressure, and baseline vessel and glyceryltrinitrate-induced dilation, did not differ among different groups ( Table 1 and Table 2 ).
Univariate analysis showed a correlation between plasma TRAIL and FMD (r = 0·33, P < 0·001), LDL-C (r = −0·23, P = 0·043), triglycerides (r = −0·22, P = 0·045), Lp(a) (r = −0·20, P = 0·049), FBG (r = −0·31, P < 0·001), 2-h BG (r = −0·28, P < 0·001), CRP (r = −0·32, P < 0·001), BMI (r = −0·25, P = 0·037) and mean blood pressure (r = −0·26, P = 0·013) in diabetic patients at baseline. To evaluate the association of the basal levels of various clinical variables with the basal level of plasma TRAIL in diabetic patients, multiple regression analysis was performed. In model 1, which included FMD, CRP, FBG, 2-h BG and HbA1c as independent variables, the results showed that FMD, CRP, FBG, 2-h BG and HbA1c are significant factors which are associated with plasma TRAIL levels. When HbA1c was replaced by LDL-C, triglycerides, Lp(a), BMI and mean blood pressure, these variables failed to emerge as significant independent determinants of TRAIL (models 2–6) (data not shown).
Also, correlation analysis showed that the absolute changes in TRAIL significantly correlated with the changes in FMD (P < 0·001) (Fig. 1), FBG (P < 0·001) and 2-h BG (P < 0·001) (Fig. 2), HbA1c (P < 0·001) (Fig. 3) and CRP (P < 0·001) (Fig. 4), and there was no significant correlation with other parameters in diabetic patients during the course of treatment.
(Enlarge Image)
Figure 1.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in FMD before and after treatment in diabetic patients.
(Enlarge Image)
Figure 2.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in plasma glucose (FBG and 2-h BG) before and after treatment in diabetic patients.
(Enlarge Image)
Figure 3.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in HbA1c before and after treatment in diabetic patients.
(Enlarge Image)
Figure 4.
Correlation analysis to evaluate correlation of changes in TRAIL with changes in CRP before and after treatment in diabetic patients.
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