Association of Carbamylated HDL and CAD in T2DM Patients
Condition: Type 2 Diabetes Mellitus With Circulatory Complciation
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Observational

Summary: 
      This is an observational cross-sectional study aimed at investigating the alterations of the
      carbamylated-HDL levels in T2DM patients, and comparing the concentration of carbamylated-HDL
      between the T2DM patients with CAD and without CAD to explore the association between
      carbamylated-HDL and risk of CAD in T2DM patients.
    

Detailed description: 
      High-density lipoprotein (HDL) is involved in various atheroprotective processes, including
      reverse cholesterol transport, inhibition of lipid oxidation and inflammatory cytokine
      secretion, endothelial repair, and antiapoptotic function, which all contribute to the
      regression of plague burden. Recent studies have shown that oxidative stress and chronic
      inflammation - both implicated in the process of diabetes - can contribute to an irreversible
      post-translational modification called carbamylation. Carbamylation levels reflect the burden
      of enhanced inflammation, oxidative stress, and renal impairment, and can serve as a
      biomarker of certain pathological conditions. Several clinical studies have demonstrated
      positive associations between cardiovascular risk, mortality, and serum carbamylation-derived
      product levels in the general population and particularly in patients with kidney failure.
      Increasing evidence also shows that carbamylated lipoprotein plays a pivotal role in
      atherosclerosis.18 However, most studies concerning carbamylation have been performed under a
      kidney disease background. Whether HDL particles in patients with type 2 diabetes mellitus
      (T2DM) show enhanced carbamylation and whether this enhancement is associated with vascular
      complications remains unknown. Thus, in the present study, the investigators aim to test
      whether HDL experiences carbamylation in T2DM patients and investigated the pro-atherogenic
      effects of carbamylated HDL on endothelial-monocyte adhesion.
    

Intervention name(s): High density lipoprotein isolation, detection and in-vitro study.
Intervention type(s): Other
Intervention description(s): All blood samples were taken on the day of cardiac catheterization after overnight fasting.High density lipoprotein from each participants was isolated and further collected for carbamylation level detection and in-vitro study.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Between September 2018 to March 2019, a total of 242 consecutive T2DM patients who visited
        Shanghai Ruijin Hospital were enrolled in this study. All patients were tested by
        angiography, with CAD diagnosed if luminal diameter narrowing was estimated visually at
        ≥50% in a major epicardial coronary artery. Patients with end-stage renal disease (ESRD) (n
        = 9), acute coronary syndrome(n = 25), heart failure (n = 21), chronic viral or bacterial
        infection (n = 7), tumors(n = 8), or immune system disorders (n = 3) were excluded from
        this study. We included 40 age- and gender-matched healthy subjects to serve as the control
        group, who had normal blood pressure, serum fasting glucose, lipid profile, and renal
        function.
      
Keywords: Carbamylation,HDL,T2DM