特发性扩张型心肌病中的胃饥饿素紊乱：心肌病病程和左心室射血分数的影响
Ghrelin Derangements in Idiopathic Dilated Cardiomyopathy: Impact of Myocardial Disease Duration and Left Ventricular Ejection Fraction.
作者信息
Aleksova Aneta, Beltrami Antonio Paolo, Bevilacqua Elisa, Padoan Laura, Santon Daniela, Biondi Federico, Barbati Giulia, Stenner Elisabetta, Gortan Cappellari Gianluca, Barazzoni Rocco, Ziberna Fabiana, Zwas Donna R, Avraham Yosefa, Agostoni Piergiuseppe, Not Tarcisio, Livi Ugolino, Sinagra Gianfranco
机构信息
Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy.
Department of Medicine (DAME), University of Udine, 33100 Udine, Italy.
出版信息
J Clin Med. 2019 Aug 1;8(8):1152. doi: 10.3390/jcm8081152.
BACKGROUND
Ghrelin may exert positive effects on cardiac structure and function in heart failure (HF) patients.
METHODS
We assessed ghrelin levels in 266 dilated cardiomyopathy (DCM) patients and in 200 age, gender and body mass index (BMI) matched controls. Further, we evaluated the expression of ghrelin and growth hormone secretagogue-receptor (GHSR) in the myocardium of 41 DCM patients and in 11 controls.
RESULTS
DCM patients had significantly lower levels of total, acylated and unacylated ghrelin when compared to controls ( < 0.05 for all). In controls, we observed a negative correlation of ghrelin with age, male gender and BMI. These correlations were lost in the DCM group, except for male gender. Total ghrelin was higher in patients with more recent diagnosis when compared to patients with longer duration of the DCM ( = 0.033). Further, total ghrelin was higher in patients with lower left ventricular systolic function (<40% LVEF, vs. 40% ≤ LVEF < 49% vs. LVEF ≥ 50%: 480.8, vs. 429.7, vs. 329.5 pg/mL, respectively, = 0.05). Ghrelin prepropeptide was expressed more in DCM patients than in controls (p = 0.0293) while GHSR was expressed less in DCM patients (p < 0.001). Furthermore, ghrelin showed an inverse correlation with its receptor (= -0.406, p = 0.009), and this receptor showed a significant inverse correlation with Interleukin-1 (= -0.422, p = 0.0103).
CONCLUSION
DCM duration and severity are accompanied by alterations in the ghrelin-GHSR system.
背景
胃饥饿素可能对心力衰竭（HF）患者的心脏结构和功能产生积极影响。
方法
我们评估了266例扩张型心肌病（DCM）患者以及200例年龄、性别和体重指数（BMI）匹配的对照者的胃饥饿素水平。此外，我们还评估了41例DCM患者和11例对照者心肌中胃饥饿素和生长激素促分泌素受体（GHSR）的表达。
结果
与对照组相比，DCM患者的总胃饥饿素、酰化胃饥饿素和去酰化胃饥饿素水平显著降低（所有均P<0.05）。在对照组中，我们观察到胃饥饿素与年龄、男性性别和BMI呈负相关。除男性性别外，这些相关性在DCM组中消失。与DCM病程较长的患者相比，近期诊断的患者总胃饥饿素水平更高（P=0.033）。此外，左心室收缩功能较低的患者总胃饥饿素水平更高（左心室射血分数<40% vs. 40%≤左心室射血分数<49% vs. 左心室射血分数≥50%：分别为480.8、429.7和329.5 pg/mL，P=0.05）。DCM患者中胃饥饿素前体肽的表达高于对照组（P=0.0293），而DCM患者中GHSR的表达低于对照组（P<0.001）。此外，胃饥饿素与其受体呈负相关（ρ=-0.406，P=0.009），且该受体与白细胞介素-1β呈显著负相关（ρ=-0.422，P=0.0103）。
结论
DCM的病程和严重程度伴随着胃饥饿素-GHSR系统的改变。
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