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脂肪细胞因子谱改变可预测2型糖尿病高血压患者左心室重构的早期阶段。

Altered adipocytokine profile predicts early stage of left ventricular remodeling in hypertensive patients with type 2 diabetes mellitus.

作者信息

Bilovol Oleksandr M, Knyazkova Iryna I, Al-Travneh Olena V, Bogun Maryna V, Berezin Alexander E

机构信息

Clinical Pharmacology and Internal Medicine Department, Kharkiv National Medical University, Kharkiv, Ukraine.

Department of Internal Medicine V. N. Karazin Kharkiv National University, Ukraine.

出版信息

Diabetes Metab Syndr. 2020 Mar-Apr;14(2):109-116. doi: 10.1016/j.dsx.2020.01.011. Epub 2020 Feb 4.

Abstract

BACKGROUND AND AIM

Adipocytokine dysfunction is considered as causative factor of target organ damage in metabolic disease. The aim of the study was to investigate whether altered adipocytokine profile predicts left ventricular (LV) remodeling in hypertensive patients with type 2 diabetes mellitus (T2DM).

METHODS

A total of 186 patients (125 hypertensive and 61 non-hypertensive individuals) with established T2DM and 20 healthy volunteers were enrolled in the study. LV remodeling was determined at baseline. Concentrations of adipocytokines were measured with ELISA at baseline.

RESULTS

The most important predictors of LV hypertrophy in T2DM patients were serum levels of omentin-1 (B-coefficient = -0.64, p = 0.001), Zinc-α2-glycoprotein [ZA2G] (B-coefficient = -0.57, p = 0.002), visfatin (B-coefficient = 0.26, p = 0.034), hs-CRP (B-coefficient = 0.38, p = 0.002), HOMA-IR (B-coefficient = 0.34, p = 0.001), age (B-coefficient = 0.31, p = 0.022), glypican-4 (B-coefficient = -0.23, p = 0.042), and male sex (B-coefficient = 0.11, p = 0.048). After entering combined depending variable (LV hypertrophy and LV diastolic dysfunction) to the model the significant predictors remained serum levels of omentin-1 (B-coefficient = -0.82, p = 0.001), ZA2G (B-coefficient = -0.54, p = 0.001) and HOMA-IR (B-coefficient = 0.44, p = 0.001). Regression analyses showed that the most influential determinants of depending variable (LV hypertrophy + LV diastolic dysfunction) in T2DM patients were omentin-1 (B-coefficient = -1.6, p = 0.001) and ZA2G (B-coefficient = -0.78, p = 0.044).

CONCLUSION

We found that serum levels of omentin-1 and ZA2G were the most important predictors for LV hypertrophy + LV diastolic dysfunction in T2DM patients. Large clinical trials are required to confirm this assumption and get clear explanation of issues unveiled.

摘要

背景与目的

脂肪细胞因子功能障碍被认为是代谢性疾病中靶器官损伤的致病因素。本研究旨在探讨脂肪细胞因子谱的改变是否能预测2型糖尿病(T2DM)高血压患者的左心室(LV)重构。

方法

本研究共纳入186例确诊为T2DM的患者(125例高血压患者和61例非高血压患者)以及20名健康志愿者。在基线时测定左心室重构情况。在基线时用酶联免疫吸附测定法(ELISA)测量脂肪细胞因子的浓度。

结果

T2DM患者左心室肥厚的最重要预测因素是血清网膜素-1水平(B系数=-0.64,p=0.001)、锌-α2-糖蛋白[ZA2G](B系数=-0.57,p=0.002)、内脂素(B系数=0.26,p=0.034)、高敏C反应蛋白(hs-CRP)(B系数=0.38,p=0.002)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)(B系数=0.34,p=0.001)、年龄(B系数=0.31,p=0.022)、磷脂酰肌醇蛋白聚糖-4(B系数=-0.23,p=0.042)和男性(B系数=0.11,p=0.048)。将联合因变量(左心室肥厚和左心室舒张功能障碍)纳入模型后,显著的预测因素仍然是血清网膜素-1水平(B系数=-0.82,p=0.001)、ZA2G(B系数=-0.54,p=0.001)和HOMA-IR(B系数=0.44,p=0.001)。回归分析表明,T2DM患者因变量(左心室肥厚+左心室舒张功能障碍)的最有影响的决定因素是网膜素-1(B系数=-1.6,p=0.001)和ZA2G(B系数=-0.78,p=0.044)。

结论

我们发现血清网膜素-1和ZA2G水平是T2DM患者左心室肥厚+左心室舒张功能障碍的最重要预测因素。需要大型临床试验来证实这一假设,并对所揭示的问题作出清晰解释。

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