心肌梗死和心力衰竭患者生长分化因子-15 与胶原代谢指标的相关性。
Correlation between growth differentiation factor-15 and collagen metabolism indicators in patients with myocardial infarction and heart failure.
机构信息
Department of Cardiology & Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Health Science Center and Key Laboratory of Molecular Ministry of Education, Cardiovascular Science, Peking University Third Hospital, Hua Yuan Bei Lu, Hai Dian District, Beijing, China.
出版信息
J Geriatr Cardiol. 2016 Jan;13(1):88-93. doi: 10.11909/j.issn.1671-5411.2016.01.002.
BACKGROUND
Growth differentiation factor (GDF)-15, a divergent member of the transforming growth factor beta super-family does appear to be up-regulated in response to experimental pressure overload and progression of heart failure (HF). HF frequently develops after myocardial infarction (MI), contributing to worse outcome. The aim of this study is to assess the correlation between GDF-15 levels and markers related to collagen turnover in different stages of HF.
METHODS
The study consists of a cohort of 179 patients, including stable angina pectoris patients (AP group, n = 50), old MI patients without HF (OMI group, n = 56), old MI patients with HF (OMI-HF group, n = 38) and normal Control group (n = 35). Both indicators reflecting the synthesis and degradation rates of collagen including precollagen I N-terminal peptide (PINP), type I collagen carboxy-terminal peptide (ICTP), precollagen III N-terminal peptide (PIIINP) and GDF-15 were measured using an enzyme-linked inmunosorbent assay.
RESULTS
The plasma GDF-15 level was higher in OMI-HF group (1373.4 ± 275.4 ng/L) than OMI group (1036.1 ± 248.6 ng/L), AP group (784.6 ± 222.4 ng/L) and Control group (483.8 ± 186.4 ng/L) (P < 0.001). The indicators of collagen turnover (ICTP, PINP, PIIINP) all increased in the OMI-HF group compared with Control group (3.03 ± 1.02 µg/L vs. 2.08 ± 0.95 µg/L, 22.2 ± 6.6 µg/L vs. 16.7 ± 5.1 µg/L and 13.2 ± 7.9 µg/L vs. 6.4 ± 2.1 µg/L, respectively; P < 0.01). GDF-15 positively correlated with ICTP and PIIINP (r = 0.302, P < 0.001 and r = 0.206, P = 0.006, respectively). GDF-15 positively correlated to the echocardiographic diastolic indicators E/Em and left atrial pressure (r = 0.349 and r = 0.358, respectively; P < 0.01), and inversely correlated to the systolic indicators left ventricular ejection fraction and the average of peak systolic myocardial velocities (Sm) (r = -0.623 and r = -0.365, respectively; P < 0.01).
CONCLUSION
Plasma GDF-15 is associated with the indicators of type I and III collagen turnover.
背景
生长分化因子 15（GDF-15）是转化生长因子-β超家族的一个分支，似乎在实验性压力超负荷和心力衰竭（HF）进展中上调。HF 常继发于心肌梗死（MI），导致预后更差。本研究旨在评估 GDF-15 水平与 HF 不同阶段胶原转化相关标志物之间的相关性。
方法
本研究包括 179 例患者，包括稳定型心绞痛患者（AP 组，n=50）、陈旧性 MI 无 HF 患者（OMI 组，n=56）、陈旧性 MI 合并 HF 患者（OMI-HF 组，n=38）和正常对照组（n=35）。采用酶联免疫吸附法测定反映胶原合成和降解速率的两种标志物，包括前胶原 I N 端肽（PINP）、I 型胶原 C 端肽（ICTP）、前胶原 III N 端肽（PIIINP）和 GDF-15。
结果
与 OMI 组（1036.1±248.6ng/L）、AP 组（784.6±222.4ng/L）和对照组（483.8±186.4ng/L）相比，OMI-HF 组（1373.4±275.4ng/L）的血浆 GDF-15 水平更高（P＜0.001）。与对照组相比，OMI-HF 组的胶原转化标志物（ICTP、PINP、PIIINP）均升高（3.03±1.02μg/L 比 2.08±0.95μg/L，22.2±6.6μg/L 比 16.7±5.1μg/L 和 13.2±7.9μg/L 比 6.4±2.1μg/L；P＜0.01）。GDF-15 与 ICTP 和 PIIINP 呈正相关（r=0.302，P＜0.001；r=0.206，P=0.006）。GDF-15 与超声心动图舒张指标 E/Em 和左心房压呈正相关（r=0.349 和 r=0.358；P＜0.01），与收缩指标左心室射血分数和收缩期心肌平均速度（Sm）呈负相关（r=-0.623 和 r=-0.365；P＜0.01）。
结论
血浆 GDF-15 与 I 型和 III 型胶原转化标志物相关。
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