2型糖尿病患者血清网膜素水平与心脏自主神经病变的相关性：一项基于医院的研究
Association of serum omentin levels with cardiac autonomic neuropathy in patients with type 2 diabetes mellitus: a hospital-based study.
作者信息
Jung Chan-Hee, Jung Sang-Hee, Kim Bo-Yeon, Kim Chul-Hee, Kang Sung-Koo, Mok Ji-Oh
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, #170 Jomaru-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 420-767, Republic of Korea.
Department of Obstetrics and Gynecology, Cha University School of Medicine, Bundang, Korea.
出版信息
Cardiovasc Diabetol. 2015 Oct 14;14:140. doi: 10.1186/s12933-015-0303-3.
BACKGROUND
Whereas a few studies have reported associations of serum omentin levels with subclinical atherosclerosis in patients with diabetes, little information is available with respect to the associations of serum omentin levels and diabetic microvascular complications. The aim of this study was to investigate the relationships of serum omentin levels and vascular complications including cardiac autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM).
METHODS
We recruited 97 patients who evaluated complications of diabetes. CAN was assessed by five standard cardiovascular reflex tests according to Ewing's protocol. Diabetic nephropathy (DN), retinopathy (DR), and peripheral neuropathy (DPN) were evaluated. Serum omentin levels were assessed by ELISA. Atherosclerotic burden was evaluated by measuring the brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI).
RESULTS
The prevalence of CAN increased borderline significantly across the omentin tertiles (p = 0.05) and CAN point increased significantly and progressively across the omentin tertiles (p = 0.013). The prevalence of other microvascular complications (DPN, DN, and DR) did not differ among omentin tertiles. The mean levels of baPWV also increased significantly and progressively across the omentin tertiles (p = 0.002). Serum omentin levels were significantly positively correlated with CAN point (p = 0.004) and borderline significantly correlated with baPWV (p = 0.05) after multivariate adjustment. Regarding linear regression analysis for CAN point, univariate regression analysis demonstrated that CAN point associated with omentin, diastolic blood pressure (DBP) and hsCRP. Multiple regression analysis revealed that omentin levels, together DBP and baPWV correlated with CAN point. This present study suggests that serum omentin levels may be independently associate with CAN in patients with T2DM.
背景
尽管有一些研究报道了糖尿病患者血清网膜素水平与亚临床动脉粥样硬化之间的关联，但关于血清网膜素水平与糖尿病微血管并发症之间的关联却知之甚少。本研究的目的是探讨2型糖尿病（T2DM）患者血清网膜素水平与包括心脏自主神经病变（CAN）在内的血管并发症之间的关系。
方法
我们招募了97名评估糖尿病并发症的患者。根据尤因方案，通过五项标准心血管反射试验评估CAN。评估糖尿病肾病（DN）、视网膜病变（DR）和周围神经病变（DPN）。通过酶联免疫吸附测定法评估血清网膜素水平。通过测量臂踝脉搏波速度（baPWV）和踝臂指数（ABI）评估动脉粥样硬化负担。
结果
CAN的患病率在网膜素三分位数中呈临界显著增加（p = 0.05），CAN评分在网膜素三分位数中显著且逐步增加（p = 0.013）。其他微血管并发症（DPN、DN和DR）的患病率在网膜素三分位数之间没有差异。baPWV的平均水平在网膜素三分位数中也显著且逐步增加（p = 0.002）。多变量调整后，血清网膜素水平与CAN评分显著正相关（p = 0.004），与baPWV临界显著相关（p = 0.05）。关于CAN评分的线性回归分析，单变量回归分析表明CAN评分与网膜素、舒张压（DBP）和高敏C反应蛋白（hsCRP）相关。多元回归分析显示，网膜素水平与DBP和baPWV共同与CAN评分相关。本研究表明，血清网膜素水平可能与T2DM患者的CAN独立相关。
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