van Dijk Peter R, Landman Gijs W D, van Essen Larissa, Struck Joachim, Groenier Klaas H, Bilo Henk J G, Bakker Stephan J L, Kleefstra Nanne
Isala, Diabetes Centre, P.O. box 10400, 8000 G.K, Zwolle, The Netherlands.
Sphingotec GmbH, Hennigsdorf, Germany.
BMC Endocr Disord. 2015 Apr 14;15:19. doi: 10.1186/s12902-015-0009-2.
The hormone somatostatin inhibits growth hormone release from the pituitary gland and is theoretically linked to diabetes and diabetes related complications. This study aimed to investigate the relationship between levels of the stable somatostatin precursor, N-terminal prosomatostatin (NT-proSST), with mortality in type 2 diabetes (T2DM) patients.
In 1,326 T2DM outpatients, participating in this ZODIAC prospective cohort study, Cox proportional hazards models were used to investigate the independent relationship between plasma NT-proSST concentrations with all-cause and cardiovascular mortality.
Median concentration of NT-proSST was 592 [IQR 450-783] pmol/L. During follow-up for 6 [3-10] years, 413 (31%) patients died, of which 176 deaths (43%) were attributable to cardiovascular causes. The age and sex adjusted hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.48 (95%CI 1.14 - 1.93) and 2.21 (95%CI 1.49 - 3.28). However, after further adjustment for cardiovascular risk factors there was no independent association of log NT-proSST with mortality, which was almost entirely attributable to adjustment for serum creatinine. There were no significant differences in Harrell's C statistics to predict mortality for the models with and without NT-proSST: both 0.79 (95%CI 0.77 - 0.82) and 0.81 (95%CI 0.77 - 0.84).
NT-proSST is unsuitable as a biomarker for cardiovascular and all-cause mortality in stable outpatients with T2DM.
激素生长抑素可抑制垂体释放生长激素，理论上与糖尿病及糖尿病相关并发症有关。本研究旨在探讨稳定的生长抑素前体N端前生长抑素（NT-proSST）水平与2型糖尿病（T2DM）患者死亡率之间的关系。
在参与这项ZODIAC前瞻性队列研究的1326例T2DM门诊患者中，采用Cox比例风险模型研究血浆NT-proSST浓度与全因死亡率和心血管死亡率之间的独立关系。
NT-proSST的中位浓度为592[四分位间距450 - 783]pmol/L。在6[3 - 10]年的随访期间，413例（31%）患者死亡，其中176例（43%）死于心血管原因。全因死亡率和心血管死亡率的年龄和性别校正风险比（HR）分别为1.48（95%置信区间1.14 - 1.93）和2.21（95%置信区间1.49 - 3.28）。然而，在进一步调整心血管危险因素后，log NT-proSST与死亡率无独立关联，这几乎完全归因于血清肌酐的调整。对于包含和不包含NT-proSST的模型，预测死亡率的Harrell's C统计量无显著差异：分别为0.79（95%置信区间0.77 - 0.82）和0.81（95%置信区间0.77 - 0.84）。
NT-proSST不适用于作为稳定的T2DM门诊患者心血管和全因死亡率的生物标志物。
