碱性成纤维细胞生长因子可预测退伍军人事务糖尿病试验参与者的心血管疾病发生。
Basic fibroblast growth factor predicts cardiovascular disease occurrence in participants from the veterans affairs diabetes trial.
机构信息
Medical Service, Department of Veterans Affairs New Jersey Health Care System , Lyons, NJ , USA ; Rutgers-Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
出版信息
Front Endocrinol (Lausanne). 2013 Nov 22;4:183. doi: 10.3389/fendo.2013.00183. eCollection 2013.
AIM
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in adults with type 2 diabetes mellitus. The aim of the present study was to test whether plasma basic fibroblast growth factor (bFGF) levels predict future CVD occurrence in adults from the Veterans Affairs Diabetes Trial (VADT).
METHODS
Nearly 400 veterans, 40 years of age or older having a mean baseline diabetes duration of 11.4 years were recruited from outpatient clinics at six geographically distributed sites in the VADT. Within the VADT, they were randomly assigned to intensive or standard glycemic treatment, with follow-up as much as seven and one-half years. CVD occurrence was examined at baseline in the patient population and during randomized treatment. Plasma bFGF was determined with a sensitive, specific two-site enzyme-linked immunoassay at the baseline study visit in all 399 subjects and repeated at the year 1 study visit in a randomly selected subset of 215 subjects.
RESULTS
One hundred and five first cardiovascular events occurred in these 399 subjects. The best fit model of risk factors associated with the time to first CVD occurrence (in the study) over a seven and one-half year period had as significant predictors: prior cardiovascular event [hazard ratio (HR) 3.378; 95% confidence intervals (CI) 3.079-3.807; P < 0.0001), baseline plasma bFGF (HR 1.008; 95% CI 1.002-1.014; P = 0.01), age (HR 1.027; 95% CI 1.004-1.051; P = 0.019), baseline plasma triglycerides (HR 1.001; 95% CI 1.000-1.002; P = 0.02), and diabetes duration-treatment interaction (P = 0.03). Intensive glucose-lowering was associated with significantly decreased hazard ratios for CVD occurrence (0.38-0.63) in patients with known diabetes duration of 0-10 years, and non-significantly increased hazard ratios for CVD occurrence (0.82-1.78) in patients with longer diabetes duration.
CONCLUSION
High level of plasma bFGF is a predictive biomarker of future CVD occurrence in this population of adult type 2 diabetes.
目的
心血管疾病（CVD）是 2 型糖尿病成年人发病率和死亡率的主要原因。本研究的目的是检验在退伍军人事务糖尿病试验（VADT）中，血浆碱性成纤维细胞生长因子（bFGF）水平是否可预测成年人未来的 CVD 发生。
方法
近 400 名年龄在 40 岁或以上的退伍军人，基线糖尿病病程平均为 11.4 年，从 VADT 六个地理分布地点的门诊招募。在 VADT 中，他们被随机分配到强化或标准血糖治疗组，随访长达 7 年半。在患者人群中在基线检查 CVD 发生情况，并在随机治疗期间进行检查。在所有 399 名受试者的基线研究访问中使用敏感、特异的双位点酶联免疫吸附试验测定血浆 bFGF，并在随机选择的 215 名受试者的一年研究访问中重复测定。
结果
在这些 399 名受试者中，发生了 105 例首次心血管事件。与长达 7 年半的时间内首次 CVD 发生（在研究中）相关的最佳风险因素模型有显著预测因子：先前的心血管事件[危险比（HR）3.378；95%置信区间（CI）3.079-3.807；P<0.0001]，基线血浆 bFGF（HR 1.008；95%CI 1.002-1.014；P=0.01），年龄（HR 1.027；95%CI 1.004-1.051；P=0.019），基线血浆甘油三酯（HR 1.001；95%CI 1.000-1.002；P=0.02），以及糖尿病病程-治疗相互作用（P=0.03）。强化血糖降低与已知糖尿病病程 0-10 年的患者发生 CVD 的风险比显著降低（0.38-0.63），而糖尿病病程较长的患者发生 CVD 的风险比非显著增加（0.82-1.78）。
结论
在该成年 2 型糖尿病人群中，高水平的血浆 bFGF 是未来 CVD 发生的预测生物标志物。
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