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2型糖尿病伴左心室扩张患者中抗β1受体和抗AT1受体自身抗体

Autoantibodies against β1 receptor and AT1 receptor in type 2 diabetes patients with left ventricular dilatation.

作者信息

Zhao Linshuang, Xu Chunyan, Xu Jinling

机构信息

Department of Endocrinology, Guangzhou Command Wuhan General Hospital, Wuhan, PR China.

出版信息

Cardiology. 2014;129(3):191-6. doi: 10.1159/000365782. Epub 2014 Oct 11.

Abstract

OBJECTIVES

To explore the relationship between the autoantibodies against the β1 and AT1 receptors and left ventricular dilatation in patients with type 2 diabetes (T2DM).

METHODS

The autoantibodies against the β1 and angiotensin II type 1 (AT1) receptors of T2DM patients with and without hypertension were screened by ELISA. Multiple logistic regression was used to analyze the risk factors for left ventricular dilatation. The reversing effect of left ventricular dilatation was evaluated after receptor blocker treatment.

RESULTS

The positive rates of autoantibodies against the β1 and AT1 receptors (43.0 and 44.1%, respectively) in T2DM patients with hypertension were significantly higher than those in normotensive patients (16.0 and 10.4%, respectively; all p < 0.01). Furthermore, among T2DM patients with hypertension, the positive rates (61.4 and 64.9%, respectively) in patients with left ventricular dilatation were remarkably higher than those with normal left ventricular dimensions (34.4 and 36.1%, respectively; all p < 0.01). The presence of β1 receptor antibody and AT1 receptor antibody were risk factors for left ventricular dilatation (p < 0.05). The curative effect of metoprolol tartrate and valsartan in reversing left ventricular hypertrophy in the group positive for autoantibodies was much better than in the negative group.

CONCLUSION

The findings show that autoantibodies against the β1 and AT1 receptors may play a role in predicting left ventricular dilatation in T2DM patients in combination with hypertension. Metoprolol tartrate and valsartan are effective and safe in the treatment of these patients.

摘要

目的

探讨2型糖尿病(T2DM)患者中抗β1和AT1受体自身抗体与左心室扩张之间的关系。

方法

采用酶联免疫吸附测定(ELISA)法筛查有或无高血压的T2DM患者的抗β1和血管紧张素II 1型(AT1)受体自身抗体。采用多因素logistic回归分析左心室扩张的危险因素。在受体阻滞剂治疗后评估左心室扩张的逆转效果。

结果

高血压T2DM患者中抗β1和AT1受体自身抗体的阳性率(分别为43.0%和44.1%)显著高于血压正常患者(分别为16.0%和10.4%;均p<0.01)。此外,在高血压T2DM患者中,左心室扩张患者的阳性率(分别为61.4%和64.9%)显著高于左心室大小正常的患者(分别为34.4%和36.1%;均p<0.01)。β1受体抗体和AT1受体抗体的存在是左心室扩张的危险因素(p<0.05)。酒石酸美托洛尔和缬沙坦对自身抗体阳性组左心室肥厚的逆转疗效明显优于阴性组。

结论

研究结果表明,抗β1和AT1受体自身抗体可能在预测合并高血压的T2DM患者左心室扩张中发挥作用。酒石酸美托洛尔和缬沙坦治疗这些患者有效且安全。

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