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在糖尿病患者下肢血管腔内再通术后,网膜素-1 与主要心血管事件的关系:一项前瞻性队列研究。

Association between omentin-1 and major cardiovascular events after lower extremity endovascular revascularization in diabetic patients: a prospective cohort study.

机构信息

Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Internal Medicine and Vascular Diseases Unit, Rome, Italy.

出版信息

Cardiovasc Diabetol. 2020 Oct 7;19(1):170. doi: 10.1186/s12933-020-01151-z.

Abstract

BACKGROUND

Cardiovascular complications represent the major cause of morbidity and mortality of type 2 diabetes mellitus (T2DM) patients. In particular, peripheral artery disease (PAD) represents a frequent T2DM vascular complication and a risk factor for the development of major adverse cardiovascular events (MACE). Among adipokines, omentin-1 serum levels are reduced in T2DM patients with PAD and are inversely related to disease severity.

OBJECTIVE

To study the relationship between omentin-1 levels, at baseline, with outcomes after endovascular procedures in T2DM patients with PAD and chronic limb-threatening ischemia (CLTI).

RESEARCH DESIGN AND METHODS

We enrolled for our prospective non-randomized study, 207 T2DM patients with PAD and CLTI, requiring revascularization. Omentin-1 serum levels were collected before revascularization and patients incidence outcomes were evaluated at 1, 3, 6 and 12 months.

RESULTS

Omentin-1 was reduced in patients with more severe disease (27.24 ± 4.83 vs 30.82 ± 5.48 ng/mL, p < 0.001). Overall, 84 MACE and 96 major adverse limb events (MALE) occurred during the 12-month follow-up. We observed that omentin-1 levels were lower in patients with MACE (26.02 ± 4.05 vs 31.33 ± 5.29 ng/mL, p < 0.001) and MALE (26.67 ± 4.21 vs 31.34 ± 5.54 ng/mL, p < 0.001). The association between omentin-1, MACE and MALE remained significant after adjusting for major risk factors in a multivariate analysis. Receiver operating characteristics (ROC) curve using omentin-1 levels predicted incidence events (area under the curve = 0.80).

CONCLUSIONS

We demonstrated that reduced omentin-1 levels, at baseline, are related with worse vascular outcomes in T2DM patients with PAD and CLTI undergoing an endovascular procedure.

摘要

背景

心血管并发症是 2 型糖尿病(T2DM)患者发病和死亡的主要原因。具体而言,外周动脉疾病(PAD)是 T2DM 的常见血管并发症,也是发生主要不良心血管事件(MACE)的危险因素。在脂肪因子中,网膜素-1 血清水平在合并 PAD 的 T2DM 患者中降低,且与疾病严重程度呈负相关。

目的

研究 T2DM 合并 PAD 和慢性肢体威胁性缺血(CLTI)患者基线时网膜素-1 水平与血管内治疗后结局之间的关系。

研究设计和方法

我们前瞻性地纳入了 207 名需要血运重建的 T2DM 合并 PAD 和 CLTI 患者进行非随机研究。在血运重建前采集网膜素-1 血清水平,评估患者在 1、3、6 和 12 个月时的结局发生率。

结果

病情较重的患者网膜素-1 水平降低(27.24±4.83 比 30.82±5.48ng/ml,p<0.001)。在 12 个月的随访期间,共有 84 例 MACE 和 96 例主要不良肢体事件(MALE)发生。我们发现 MACE(26.02±4.05 比 31.33±5.29ng/ml,p<0.001)和 MALE(26.67±4.21 比 31.34±5.54ng/ml,p<0.001)患者的网膜素-1 水平较低。多因素分析调整主要危险因素后,网膜素-1 与 MACE 和 MALE 之间的相关性仍有统计学意义。使用网膜素-1 水平的受试者工作特征(ROC)曲线预测事件发生率(曲线下面积=0.80)。

结论

我们证明了基线时网膜素-1 水平降低与 T2DM 合并 PAD 和 CLTI 患者血管内治疗后较差的血管结局相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd07/7542958/fe0e0fdda32e/12933_2020_1151_Fig1_HTML.jpg

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