Marmara University Medical School, Section of Endocrinology and Metabolism, Istanbul, Turkey.
Acta Diabetol. 2013 Apr;50(2):155-61. doi: 10.1007/s00592-010-0235-z. Epub 2010 Nov 12.
Diabetic cardiomyopathy is an important complication of type 1 diabetes mellitus. Diastolic heart failure is an early manifestation of diabetic cardiac disease. Nt-proBNP is a valuable marker of ventricular dysfunction. The aim of this study was to determine Nt-proBNP concentrations in type 1 diabetic patients and determine their relationship with ventricular diastolic dysfunction (DD) and carotid artery intima media thickness (CIMT) measurements. Sixty-seven type 1 diabetic patients (30.2 ± 8.0 years; W/M: 24/43) without known cardiovascular disease and 48 healthy controls (30.5 ± 6.4 years; W/M: 19/29) were recruited. Nt-proBNP levels were measured. Conventional and tissue Doppler echocardiography were used to evaluate left ventricular diastolic function and CIMT. Nt-proBNP in diabetic patients was significantly higher than in controls (38 ± 34.8 vs. 15.1 ± 12.7 pg/ml) (P = 0.004). Ea level was higher (12.3 ± 3 vs. 10.3 ± 4 cm/s, P = 0.003) and E/Ea ratio was lower in patients (6.6 ± 2.5 vs. 9.7 ± 5.9, P = 0.001) compared with controls. Ratio of DD was higher in patients than controls (11.1 vs. 2.1%, P = 0.01). CIMT measurements in diabetic patients were higher than controls (0.54 ± 0.11 vs. 0.48 ± 0.05 mm, P = 0.02). Logistic regression revealed age and HbA1c to be independently associated with the presence of DD. Nt-proBNP levels are elevated in type 1 diabetic patients without overt cardiovascular disease and the presence of DD is increased in diabetic patients in comparison with controls. Nt-proBNP levels do not seem to be related to the presence of DD and subclinical atherosclerosis in this group of patients.
糖尿病性心肌病是 1 型糖尿病的重要并发症。舒张性心力衰竭是糖尿病性心脏疾病的早期表现。NT-proBNP 是心室功能障碍的有价值标志物。本研究旨在确定 1 型糖尿病患者的 NT-proBNP 浓度，并确定其与心室舒张功能障碍（DD）和颈动脉内膜中层厚度（CIMT）测量值的关系。
招募了 67 名无已知心血管疾病的 1 型糖尿病患者（30.2±8.0 岁；W/M：24/43）和 48 名健康对照者（30.5±6.4 岁；W/M：19/29）。测量了 NT-proBNP 水平。使用常规和组织多普勒超声心动图评估左心室舒张功能和 CIMT。
糖尿病患者的 NT-proBNP 水平明显高于对照组（38±34.8 比 15.1±12.7 pg/ml）（P=0.004）。Ea 水平较高（12.3±3 比 10.3±4 cm/s，P=0.003），E/Ea 比值较低（6.6±2.5 比 9.7±5.9，P=0.001）。与对照组相比，患者的 DD 比值较高（11.1 比 2.1%，P=0.01）。糖尿病患者的 CIMT 测量值高于对照组（0.54±0.11 比 0.48±0.05 mm，P=0.02）。
逻辑回归显示年龄和 HbA1c 与 DD 的存在独立相关。
在无明显心血管疾病的 1 型糖尿病患者中，NT-proBNP 水平升高，与对照组相比，糖尿病患者的 DD 发生率增加。在这群患者中，NT-proBNP 水平似乎与 DD 的存在和亚临床动脉粥样硬化无关。
