The role of surfactant proteins SP-A and SP-D in the pathogenesis of carbohydrate metabolism disorders

Aim: To investigate the associations between plasma levels of surfactant proteins SP-A and SP-D and characteristics of carbohydrate and lipid metabolism. Materials and Methods: A cross-sectional observational study included 174 residents of Novosibirsk aged 45 to 69 years. All participants underwent fasting blood tests to measure glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and serum levels of surfactant proteins SP-A and SP-D using enzyme-linked immunosorbent assay (ELISA). Results: In the overall study, an inverse correlation was found between SP-A and hyperglycemia meeting the criteria for diabetes mellitus (r = -0.204; p = 0.007). This suggests that elevated blood glucose levels may negatively affect SP-A concentration, potentially impairing lung function in patients with hyperglycemia. In individuals with hyperglycemia (glucose ≥ 7 mmol/L), inverse associations were also observed between SP-A and key lipid metabolism parameters: TG (r = -0.441; p = 0.035), LDL-C (r = -0.501; p = 0.015), and the TyG index (r = -0.455; p = 0.029). Conclusion: This based study in Novosibirsk revealed significant associations between the level of pulmonary surfactant protein SP-A and indicators of carbohydrate and lipid metabolism. These findings open new avenues for further research into the role of surfactant proteins in the pathogenesis of metabolic diseases, as well as for developing strategies to prevent and treat complications associated with hyperglycemia and dyslipidemia.

surfactant proteins, SP-A, SP-D, carbohydrate metabolism, hyperglycemia, diabetes mellitus, dyslipidemia

1. Nikolaev K. Yu., Kharlamova O.S., Kosarev I.A., Dadashova N.F., Lapitskaya Ya.K. SP-A and SP-D surfactant proteins and conventional risk factors for chronic non-infectious human diseases. Sibirskij nauchnyj medicinskij zhurnal = Siberian Scientific Medical Journal. 2023;43(3):28-38. (In Russ.) doi: 10.18699/SSMJ20230303.@@ Николаев К.Ю., Харламова О.С., Косарев И.А., Дадашова Н.Ф., Лапицкая Я.К. Белки сурфактанта SP-A, SP-D и конвенциональные факторы риска хронических неинфекционных заболеваний человека. Сибирский научный медицинский журнал. 2023;43(3):28-38. doi: 10.18699/SSMJ20230303.

2. Zaytseva A.A., Bukreeva E.B., Ageeva T.S., Zorkaltsev M.A., Saprina T.V., Udodov V.D., Ardashirov M.M. Features of the clinical presentation and course of community-acquired pneumonia against the background of type 2 diabetes mellitus. Bulletin of Siberian Medicine. 2022;21(2):145-151. (In Russ.) doi: 10.20538/1682-0363-2022-2-145-151.@@ Зайцева А.А., Букреева Е.Б., Агеева Т.С., Зоркальцев М.А., Саприна Т.В., Удодов В.Д., Ардаширов М.М. Особенности клиники и течения внебольничной пневмонии на фоне сахарного диабета 2-го типа. Бюллетень сибирской медицины. 2022;21(2):145-151. doi: 10.20538/1682-0363-2022-2-145-151.

3. Khudiakova A.D., Polonskaya Y.V., Shramko V.S. et al. Blood Adipokines/Cytokines in Young People with Chronic Bronchitis and Abdominal Obesity. Biomolecules. 2022;12(10):1502. doi: 10.3390/biom12101502.

4. López-Cano C., Ciudin A., Sánchez E. et al. Liraglutide Improves Forced Vital Capacity in Individuals With Type 2 Diabetes: Data From the Randomized Crossover LIRALUNG Study. Diabetes. 2022 Feb 1;71(2):315-320. doi: 10.2337/db21-0688.

5. Kashtanova E.V., Polonskaya Y.V., Striukova E.V. et al. Blood Levels of Indicators of Lower Respiratory Tract Damage in Chronic Bronchitis in Patients with Abdominal Obesity. Diagnostics (Basel). 2022 Jan 25;12(2):299. doi: 10.3390/diagnostics12020299.

6. Nikolaev K.Y., Shevela A.I., Mustafina S.V. et al. The Impact of Hypoglycemic Therapy on the Prognosis for Acute Coronary Syndrome in Patients with Type 2 Diabetes. J Pers Med. 2022 May 22;12(5):845. doi: 10.3390/jpm12050845.

7. Lu Y., Li Y., Li G., Lu H. Identification of potential markers for type 2 diabetes mellitus via bioinformatics analysis. Mol Med Rep. 2020;22(3):1868-1882. doi: 10.3892/mmr.2020.11281.

8. Nikolaev K.Yu., Bondareva K.I., Kovaleva A.Ya., Lifshits G.I. Estimation of metformin and other sugar reducing therapy influence on the outcomes in patients with acute coronary syndrome and diabetes mellitus type II.Complex Issues of Cardiovascular Diseases. 2021;10(4): 39-47. (In Russ.) doi: 10.17802/2306-1278-2021-10-4-39-47.@@ Николаев К.Ю., Бондарева К.И., Ковалева А.Я., Лифшиц Г.И. Оценка влияния метформина и терапии другими сахароснижающими препаратами на исходы заболевания при остром коронарном синдроме у пациентов с сахарным диабетом второго типа. Комплексные проблемы сердечно-сосудистых заболеваний. 2021;10(4):39-47. doi: 10.17802/2306-1278-2021-10-4-39-47.

9. López-Cano C., Lecube A., García-Ramírez M. et al. Serum Surfactant Protein D as a Biomarker for Measuring Lung Involvement in Obese Patients With Type 2 Diabetes. J Clin Endocrinol Metab. 2017 Nov 1;102(11):4109-4116. doi: 10.1210/jc.2017-00913.

10. Kale K., Vishwekar P., Balsarkar G., Jassawalla M.J., Sawant G., Madan T. Differential levels of surfactant protein A, surfactant protein D, and progesterone to estradiol ratio in maternal serum before and after the onset of severe early-onset preeclampsia. Am J Reprod Immunol. 2020 Feb;83(2): e13208. doi: 10.1111/aji.13208.

11. Watson A., Madsen J., Clark H.W. SP-A and SP-D: Dual Functioning Immune Molecules With Antiviral and Immunomodulatory Properties. Front Immunol. 2021;11:622598. doi: 10.3389/fimmu.2020.622598.

12. Nikolaev K.Yu., Bondareva K.I., Kovaleva A.Ya., Lifshits G.I. Peculiarities of hypoglycaemic therapy in acute coronary syndrome in patients with type 2 diabetes mellitus. Patologiya krovoobrashcheniya i kardiokhirurgiya. 25. 27. 10.21688/1681-3472-2021-2-27-37. (In Russ.) doi: 10.21688/1681-3472-2021-2-27-37.@@ Николаев К.Ю., Бондарева К.И., Ковалева А.Я., Лифшиц Г.И. Особенности сахароснижающей терапии при остром коронарном синдроме у пациентов с сахарным диабетом второго типа. Патология кровообращения и кардиохирургия. 2021;25(2):27-37. doi: 10.21688/1681-3472-2021-2-27-37.

13. Ko S.H., Jung Y. Energy Metabolism Changes and Dysregulated Lipid Metabolism in Postmenopausal Women. Nutrients. 2021;13(12):4556. doi: 10.3390/nu13124556.