The Journal of Practical Medicine >
Investigation of oxidised low⁃density lipoprotein as a risk assessment indicator in patients with type 2 diabetes mellitus combined with pulmonary tuberculosis
Received date: 2024-02-29
Online published: 2024-07-15
Objective to explore the risk assessment potential of oxLDL in patients with T2DM combined with PTB. Methods A prospective study was conducted， which included 60 cases of simple hyperlipidemia， 100 cases of PTB， 100 cases of T2DM， and 100 cases of T2DM combined with PTB. These patients visited the outpatient department of our center from June 2022 to June 2023. The PTB group， T2DM group， and T2DM combined with PTB group were further divided into subgroups based on normal blood lipids （40 cases） and hyperlipidemia （60 cases）， totaling 360 cases in the case group. Additionally， a control group consisting of 60 healthy individuals was included. The age range for inclusion in the study was between 35 to70 years old. Venous blood samples were collected from each group to detect HbA1c， INS， FSG， CHOL， TG， HDL， LDL， ApoA I and Apo B. OxLDL levels were measured using the ELISA method. Differences in levels between groups were compared. Multivariate logistic regression analysis was applied to assess the association between oxLDL levels and PTB as well as T2DM combined with PTB. Results There were no statistically significant differences in BMI， blood sugar， blood lipids， and insulin resistance between the T2DM hyperlipidemia subgroup and the T2DM combined with PTB hyperlipidemia subgroup. The oxLDL level in the T2DM hypertipidemia subgroup was more than double that of the control group， while the oxLDL level in the subgroup with normal blood lipids was significantly higher than that of the control group. Moreover， both the T2DM combined with PTB hyperlipidemia subgroup and simple hyperlipidemia group exhibited significantly elevated levels of oxLDL compared to the control group； however， there were no statistically significant differences when compared to the PTB hyperlipidemia subgroup. Correlation analysis revealed a significant positive linear correlation between TG and LDL with oxLDL in both the T2DM hyperlipidemia subgroup and the T2DM combined with PTB hyperlipidemia subgroup （R = 0.352， P < 0.05）. Additionally， CHOL and LDL levels in the PTB hyperlipidemia subgroup also showed a significant positive correlation with oxLDL （R = 0.441， P < 0.05）. Multivariate logistic regression analysis indicated that having oxLDL levels more than double that of the control group was an independent risk factor for both PTB and T2DM combined with PTB （P < 0.05）. Conclusion The significantly elevated levels of oxLDL may serve as a potential risk factor for the comorbidity of T2DM and PTB. It is recommended to consider oxLDL levels exceeding twice those of the control group as a clinically meaningful pathological threshold for further assessment.
Jing GUI , Feng WANG , Hui YANG , Yumao CAI , Chuangyue. HONG . Investigation of oxidised low⁃density lipoprotein as a risk assessment indicator in patients with type 2 diabetes mellitus combined with pulmonary tuberculosis[J]. The Journal of Practical Medicine, 2024 , 40(14) : 1995 -2002 . DOI: 10.3969/j.issn.1006-5725.2024.14.016
| 1 | 杨子龙，袁园，汪敏，等. 糖尿病与肺结核共病结核分枝杆菌耐药情况分析［J］. 实用医学杂志， 2023， 39（11）： 1359-1363. doi:10.3969/j.issn.1006-5725.2023.11.007 |
| 2 | 方伟明，汤春梅，肖海浩，等. 肺结核治愈但致肺结构性损坏后咳嗽咳痰患者的综合特征［J］. 实用医学杂志， 2020， 36（9）：1203-1208. doi:10.3969/j.issn.1006-5725.2020.09.017 |
| 3 | 国家老年医学中心，中华医学会老年医学分会，中国老年保健协会糖尿病专业委员会. 中国老年糖尿病诊疗指南（2021年版）［J］ . 中华糖尿病杂志， 2021， 13（1）：14-46. doi:10.3760/cma.j.cn115791-20201209-00707 |
| 4 | WHO. Global tuberculosis report 2021［R］ . Geneva： World Health Organization. 2021. |
| 5 | PING P A， ZAKARIA R， ISLAM M A， et al. Prevalence and Risk Factors of Latent Tuberculosis Infection （LTBI） in Patients with Type 2 Diabetes Mellitus （T2DM） ［J］. Int J Environ Res Public Health， 2021， 18（1） ：305. doi:10.3390/ijerph18010305 |
| 6 | VRIELING F， WILSON L， RENSEN P C N， et al. Oxidized low-density lipoprotein （oxLDL） supports mycobacterium tuberculosis survival in macrophages by inducing lysosomal dysfunction ［J］. PLoS Pathog， 2019， 15（4）：e1007724. doi:10.1371/journal.ppat.1007724 |
| 7 | SHIM D， KIM H， SHIN S J. Mycobacterium tuberculosis infection-driven foamy macrophages and their implications in tuberculosis control as targets for host-directed therapy ［J］. Front Immunol， 2020， 11：910. doi:10.3389/fimmu.2020.00910 |
| 8 | DJAHARUDDIN I， AMIR M， QANITHA A. Exploring the link between cardiovascular risk factors and manifestations in latent tuberculosis infection： a comprehensive literature review［J］. Egypt Heart J， 2023， 75（1）： 43. doi:10.1186/s43044-023-00370-5 |
| 9 | 诸骏仁，高润霖，赵水平，等. 中国成人血脂异常防治指南（2016年修订版）［J］， 中华心血管病杂志， 2016，44（10）： 833-853. |
| 10 | 中国老年医学学会老年内分泌代谢分会，国家老年疾病临床医学研究中心（解放军总医院），中国老年糖尿病诊疗措施专家共识编写组. 中国老年2型糖尿病诊疗措施专家共识（2018年版）［J］. 中华内科杂志， 2018， 57（9）： 626-641. doi:10.3760/cma.j.issn.0578-1426.2018.09.004 |
| 11 | 中华人民共和国国家卫生和计划生育委员会. 肺结核诊断标准（WS 288-2017）［J/CD］. 新发传染病电子杂志， 2018， 3（1）： 59-61. doi:10.3877/j.issn.2096-2738.2018.01.017 |
| 12 | 殷琳，李刚. 血脂异常的流行病学及预防措施［J］. 中国临床保健杂志， 2021， 24（6）： 733-736. doi:10.3969/J.issn.1672-6790.2021.06.003 |
| 13 | ZHANG M， HE J Q. Impacts of metformin on tuberculosis incidence and clinical outcomes in patients with diabetes： a systematic review and meta-analysis ［J］. Eur J Clin Pharmacol， 2019， 76 （2）： 149-159. doi:10.1007/s00228-019-02786-y |
| 14 | VRIELING F， RONACHER K， KLEYNHANS L， et al. Patients with concurrent tuberculosis and diabetes have a proatherogenic plasma lipid profile ［J］. EBio Medicine， 2018， 32： 192-200. doi:10.1016/j.ebiom.2018.05.011 |
| 15 | SHIM D， KIM H， SHIN S J， et al. Mycobacterium tuberculosis infection-driven foamy macrophages and their implications in tuberculosis control as targets for host-directed therapy ［J］. Front Immunol， 2020， 5 （11）： 910. |
| 16 | XING L， JING L I， TIAN Y， et al. Epidemiology of dyslipidemia and associated cardiovascular risk factors ［J］. Nutr Metab Cardiovasc Dis， 2020， 30（12）： 2262-2270. doi:10.1016/j.numecd.2020.07.032 |
| 17 | BANERJEE J， MISHRA N， DAMLE G，et al. Beyond LDL-c： The importance of serum oxidized LDL in predicting risk for type 2 diabetes in the middle-aged Asian Indians ［J］.Diabetes Metab Syndr， 2019，13（1）：206-213. doi:10.1016/j.dsx.2018.08.036 |
| 18 | LUC K， SCHRAMM-LUC A， GUZIK T J， et al. Oxidative stress and inflammatory markers in prediabetes and diabetes ［J］. J Physiol Pharmacol， 2019， 70（6）：809-824. |
| 19 | MARIN M T， DASARI P S， TRYGGESTAD J B， et al. Oxidized HDL and LDL in adolescents with type 2 diabetes compared to normal weight and obese peers. Journal of diabetes and its complications［J］. J Diabetes Complications， 2015， 29（5）： 679-685. doi:10.1016/j.jdiacomp.2015.03.015 |
| 20 | SOH A Z， CHEE C B， WANG Y T， et al. Dietary cholesterol increases the risk whereas PUFAs reduce the risk of active tuberculosis in Singapore Chinese［J］. J Nutr， 2016，146（5）： 1093-1100. doi:10.3945/jn.115.228049 |
| 21 | YU Q， WENG W J， LUO H， et al. The novel predictive biomarkers for type 2 diabetes mellitus in active pulmonary tuberculosis patients.Infection and drug resistance［J］. Infect Drug Resist， 2022，15：4529-4539. doi:10.2147/idr.s377465 |
/
| 〈 |
|
〉 |