Journal of diabetes investigation · 2026
Cholesterol accumulation in monocytes is associated with the severity of diabetic complications and the efficacy of glycemic control interventions in patients with type 2 diabetes.
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Okuma Hideyuki, Tsutsumi Takahiro, Miyazaki Asako, Tsuchiya Kyoichiro
Аннотация
AIMS/INTRODUCTION: Monocyte dysfunction is central to the pathogenesis of diabetes. This study investigated the association between cholesterol accumulation in monocytes and diabetic complications as well as post-discharge glycemic control.
MATERIALS AND METHODS: We conducted a retrospective two-part study. Study 1, a cross-sectional study, included 40 patients with type 2 diabetes mellitus to assess the associations between monocyte cholesterol levels and diabetic complication indices. Study 2, a longitudinal study, included 19 patients with type 2 diabetes mellitus hospitalized for an approximately 2-week educational program. Changes in monocyte cholesterol levels from admission to discharge were compared between two groups: those whose hemoglobin A1c (HbA1c) increased 3 months after discharge (HbA1c elevated group; n = 10) and those whose HbA1c decreased or remained stable (HbA1c non-elevated group; n = 9).
RESULTS: In Study 1, monocyte cholesterol levels correlated with the severity of diabetic complications, including carotid intima-media thickness, the fibrosis-4 index, and retinopathy stage. In Study 2, during hospitalization, no significant change in monocyte cholesterol levels was observed in all patients, while a significant decrease was demonstrated in the HbA1c non-elevated group.
CONCLUSIONS: Monocytic cholesterol accumulation is associated with the severity of diverse diabetic complications and predicts the risk of glycemic deterioration after discharge. These findings suggest that monocytic cholesterol could serve as a novel translational biomarker for 'metabolic memory' and therapeutic resistance in type 2 diabetes mellitus.
MATERIALS AND METHODS: We conducted a retrospective two-part study. Study 1, a cross-sectional study, included 40 patients with type 2 diabetes mellitus to assess the associations between monocyte cholesterol levels and diabetic complication indices. Study 2, a longitudinal study, included 19 patients with type 2 diabetes mellitus hospitalized for an approximately 2-week educational program. Changes in monocyte cholesterol levels from admission to discharge were compared between two groups: those whose hemoglobin A1c (HbA1c) increased 3 months after discharge (HbA1c elevated group; n = 10) and those whose HbA1c decreased or remained stable (HbA1c non-elevated group; n = 9).
RESULTS: In Study 1, monocyte cholesterol levels correlated with the severity of diabetic complications, including carotid intima-media thickness, the fibrosis-4 index, and retinopathy stage. In Study 2, during hospitalization, no significant change in monocyte cholesterol levels was observed in all patients, while a significant decrease was demonstrated in the HbA1c non-elevated group.
CONCLUSIONS: Monocytic cholesterol accumulation is associated with the severity of diverse diabetic complications and predicts the risk of glycemic deterioration after discharge. These findings suggest that monocytic cholesterol could serve as a novel translational biomarker for 'metabolic memory' and therapeutic resistance in type 2 diabetes mellitus.