半乳糖凝集素-3 与 2 型糖尿病患者心血管事件和全因死亡率的关系。

Galectin-3 and risk of cardiovascular events and all-cause mortality in type 2 diabetes.

机构信息

Department of Medicine, University of Hong Kong, Hong Kong.

Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong.

出版信息

Diabetes Metab Res Rev. 2019 Feb;35(2):e3093. doi: 10.1002/dmrr.3093. Epub 2018 Nov 15.

DOI:10.1002/dmrr.3093

PMID:30378236

Abstract

AIMS

Recent clinical studies have shown that galectin-3 is a prognostic indicator in patients with coronary heart disease and in patients with heart failure. Experimental data suggest that galectin-3 may play a role in atherogenesis. We have evaluated whether serum galectin-3 level is associated with cardiovascular outcome in type 2 diabetes.

MATERIALS AND METHODS

Galectin-3 was measured in baseline samples in 1495 persons with type 2 diabetes. The primary cardiovascular outcome, incident cardiovascular events, was defined as first non-fatal myocardial infarction, non-fatal stroke, coronary revascularization, or death from cardiovascular cause. The secondary outcome was all-cause mortality.

RESULTS

At baseline, 12% of the subjects had prevalent cardiovascular disease. Serum galectin-3 was increased in the group with incident cardiovascular events compared with those who remained free of events during follow up (9.03 ± 2.98 ng/mL vs 8.15 ± 2.76, P < 0.01). Serum galectin-3 was also significantly increased in those subjects with a fatal outcome. The hazard ratios (HR) for cardiovascular events and all-cause mortality for individuals in the top quartile were 2.50 (95% CI 1.87, 3.36, P < 0.001) and 3.92 (95%CI 2.55, 6.01, P < 0.001), respectively. In a multivariate Cox regression analysis including traditional risk factors, log (eGFR), baseline albuminuria, and cardiovascular disease status, the HR per standard deviation change in galectin-3 was 1.13 (95% CI 1.02, 1.26, P = 0.02) for cardiovascular events and 1.17 (95% CI 1.01, 1.35, P = 0.04) for all-cause mortality.

CONCLUSIONS

Serum galectin-3 is associated with adverse cardiovascular outcomes in persons with type 2 diabetes independent of traditional risk factors.

摘要

目的

最近的临床研究表明，半乳糖凝集素-3 是冠心病和心力衰竭患者的预后指标。实验数据表明，半乳糖凝集素-3 可能在动脉粥样硬化形成中发挥作用。我们评估了 2 型糖尿病患者的血清半乳糖凝集素-3 水平是否与心血管结局相关。

材料和方法

在 1495 名 2 型糖尿病患者的基线样本中测量了半乳糖凝集素-3。主要心血管结局事件，即首发非致死性心肌梗死、非致死性卒中和冠状动脉血运重建，或心血管原因导致的死亡，定义为心血管事件。次要结局为全因死亡率。

结果

基线时，12%的受试者存在心血管疾病。与随访期间无事件发生的患者相比，发生心血管事件的患者血清半乳糖凝集素-3水平升高（9.03±2.98ng/ml比 8.15±2.76ng/ml，P<0.01）。死亡结局患者的血清半乳糖凝集素-3水平也显著升高。 quartile 最高四分位的个体心血管事件和全因死亡率的风险比（HR）分别为 2.50（95%CI 1.87，3.36，P<0.001）和 3.92（95%CI 2.55，6.01，P<0.001）。在包括传统危险因素、log（eGFR）、基线白蛋白尿和心血管疾病状态的多变量 Cox 回归分析中，半乳糖凝集素-3 每标准偏差变化的 HR 为 1.13（95%CI 1.02，1.26，P=0.02）心血管事件和 1.17（95%CI 1.01，1.35，P=0.04）全因死亡率。