1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Department of Cardiology and Hypertension, Central Clinical Hospital, the Ministry of the Interior and Administration, Warsaw, Poland.
Diabetes Metab Res Rev. 2019 Feb;35(2):e3098. doi: 10.1002/dmrr.3098. Epub 2018 Dec 13.
To investigate the association of leptin, resistin, and tumour necrosis factor α (TNF-α) with prognosis in type 2 diabetes (T2D).
Analysis included 284 T2D patients. Apart from routine laboratory parameters, baseline leptin, resistin, and TNF-α concentrations were measured. Patients were followed for a median of 5.4 years. The primary endpoint was all-cause death at follow-up. The secondary endpoint was a composite of death, acute coronary syndrome, and stroke or transient ischemic attack.
At baseline, median age was 68 years, and 48% of patients were female. Data on the primary endpoint were obtained for all patients: 32 (11%) died during follow-up. Data on the secondary endpoint were available for 230 patients, of whom 45 (20%) reached the secondary endpoint. In univariate analyses, older age, heart failure, lower-glomerular filtration rate, and higher resistin, TNF-α and NT-proBNP concentrations were predictors of the study endpoints. Of these variables, only resistin remained an independent predictor of both study endpoints in multivariate models. In receiver-operating characteristic analysis, area under the curve for resistin was 0.7. Resistin concentration of greater than or equal to 11.4 ng/mL had sensitivity of 41% and specificity of 91% for prediction of death at follow-up (Youden's index).
Higher resistin is associated with reduced survival in T2D, irrespectively of TNF-α. Resistin concentration of above 11 ng/mL indicates T2D patients at an increased risk of unfavourable outcomes. Leptin was not a prognostic factor. These results suggest that in T2D, association of resistin with unfavourable outcomes might, at least in part, result from its pro-inflammatory properties.
探讨瘦素、抵抗素和肿瘤坏死因子-α（TNF-α）与 2 型糖尿病（T2D）患者预后的关系。
分析纳入 284 例 T2D 患者。除常规实验室参数外，还检测了基线时瘦素、抵抗素和 TNF-α的浓度。中位随访时间为 5.4 年。主要终点为随访期间的全因死亡。次要终点为死亡、急性冠状动脉综合征、卒中和短暂性脑缺血发作的复合终点。
基线时，患者中位年龄为 68 岁，48%为女性。所有患者均获得了主要终点数据：32 例（11%）在随访期间死亡。230 例患者中有次要终点数据，其中 45 例（20%）达到次要终点。单因素分析显示，年龄较大、心力衰竭、肾小球滤过率较低以及抵抗素、TNF-α和 NT-proBNP 浓度较高与研究终点相关。在多变量模型中，这些变量中只有抵抗素仍然是研究终点的独立预测因子。在受试者工作特征分析中，抵抗素曲线下面积为 0.7。抵抗素浓度大于或等于 11.4ng/ml 时，预测随访期间死亡的敏感性为 41%，特异性为 91%（约登指数）。
抵抗素水平升高与 T2D 患者生存率降低相关，而与 TNF-α无关。抵抗素浓度高于 11ng/ml 提示 T2D 患者发生不良结局的风险增加。瘦素不是预后因素。这些结果表明，在 T2D 中，抵抗素与不良结局的相关性至少部分可能源于其促炎特性。
