Hansen Maria Lyck, Rasmussen Lars Melholt
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark; Centre of Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Denmark.
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark; Centre of Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Denmark.
J Diabetes Complications. 2015 Apr;29(3):362-6. doi: 10.1016/j.jdiacomp.2015.01.003. Epub 2015 Jan 13.
Diabetes is related to increased risk of cardiovascular disease, and arterial stiffness and its consequences may be the factor connecting the two. Arterial stiffness is often measured by carotid-femoral pulse wave velocity (cf-PWV), but no plasma biomarker reflecting arterial stiffness is available. Fibulin-1 is an extracellular matrix protein, up-regulated in arterial tissue and in plasma in patients with type 2 diabetes. We aimed to evaluate the association between plasma fibulin-1 and arterial stiffness measured by cf PWV in a group of patients with diabetes, and one without, all undergoing coronary artery bypass grafting.
Pulse wave velocity (PWV) and pulse wave analysis including augmentation index (Aix75) was measured in 273 patients, who subsequently underwent a coronary by-pass operation. Plasma samples were drawn and information was gathered on diabetes status, HbA1c, lipids, medication, body mass index, co-morbidities and smoking status. Carotid artery intima-media thickness, as well as estimation of carotid artery plaque burden, and distal blood pressure was also obtained.
Sixty three patients had diabetes, and this group had significantly higher levels of plasma fibulin-1, PWV and Aix75, compared to the 210 patients who did not have diabetes. In univariate analysis fibulin-1 and pulse wave velocity were not correlated in either group whereas fibulin-1 in patients without diabetes was correlated to Aix75.
Fibulin-1 and arterial stiffness indices are not directly related in patients with cardiac disease, despite the fact that both measures are increased among patients with diabetes.
糖尿病与心血管疾病风险增加相关，动脉僵硬度及其后果可能是连接二者的因素。动脉僵硬度常通过颈股脉搏波速度（cf-PWV）来测量，但尚无反映动脉僵硬度的血浆生物标志物。纤连蛋白-1是一种细胞外基质蛋白，在2型糖尿病患者的动脉组织和血浆中上调。我们旨在评估一组糖尿病患者和一组非糖尿病患者（均接受冠状动脉搭桥术）中血浆纤连蛋白-1与通过cf PWV测量的动脉僵硬度之间的关联。
对273例随后接受冠状动脉搭桥手术的患者测量脉搏波速度（PWV）和包括增强指数（Aix75）在内的脉搏波分析。采集血浆样本，并收集有关糖尿病状态、糖化血红蛋白、血脂、药物治疗、体重指数、合并症和吸烟状况的信息。还获取了颈动脉内膜中层厚度、颈动脉斑块负担估计值和远端血压。
63例患者患有糖尿病，与210例无糖尿病患者相比，该组患者的血浆纤连蛋白-1、PWV和Aix75水平显著更高。在单变量分析中，两组中纤连蛋白-1与脉搏波速度均无相关性，而无糖尿病患者的纤连蛋白-1与Aix75相关。
尽管在糖尿病患者中纤连蛋白-1和动脉僵硬度指标均升高，但在心脏病患者中纤连蛋白-1与动脉僵硬度指标无直接关联。
