骨保护素水平升高与口服降糖药治疗的 2 型糖尿病患者的心迷走神经调节受损有关。

Increased osteoprotegerin level is associated with impaired cardiovagal modulation in type-2 diabetic patients treated with oral antidiabetic drugs.

机构信息

Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605 006, India.

Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

BMC Cardiovasc Disord. 2020 Oct 20;20(1):453. doi: 10.1186/s12872-020-01729-1.

DOI:10.1186/s12872-020-01729-1

PMID:33081726

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7574185/

Abstract

BACKGROUND

An increased osteoprotegerin (OPG) level has been reported in both type-2 diabetes mellitus (T2DM) and cardiovascular diease (CVD) that are linked to sympathovagal imbalance (SVI). We explored the link of osteoprotegerin with cardiovagal modulation in T2DM.

METHODS

We assessed fasting serum OPG, high-sensitive C-reactive protein (hsCRP), glucose, insulin and lipid profile in patients having T2DM receiving oral antidiabetic drugs (OAD) (n = 42) compared with age, gender and body composition-matched healthy participants without diabetes (n = 42). Rate pressure product (RPP), spectral indices of heart rate variability (HRV) and body composition were recorded in both the groups. Association of HOMA-IR and OPG with various parameters were assessed.

RESULTS

Osteoprotegerin, HOMA-IR, hsCRP, coronary lipid risk factor were significantly increased, markers of cardiovagal modulation (TP, SDNN, RMSSD) were considerably decreased, ratio of low-frequency to high-frequency (LH-HF ratio), the indicator of SVI, and RPP, the marker of myocardial work stress were significantly higher in patients with diabetes, suggesting an overall elevated CVD risks in them. HOMA-IR was correlated with RMSSD, lipid risk factors and OPG. Rise in OPG was correlated with decreased cardiovagal modulation in patients with diabetes. There was significant contribution of OPG in decreasing TP, suggesting impaired cardiovagal modulation.

CONCLUSION

T2DM patients receiving OAD had higher cardiometabolic risks compared to age, gender and body composition-matched healthy individuals. Increased level of OPG is linked to decreased cardiovagal modulation in T2DM patients.

摘要

背景

已有研究报道，2 型糖尿病（T2DM）和心血管疾病（CVD）患者的骨保护素（OPG）水平升高，而这两种疾病都与交感神经-迷走神经失衡（SVI）有关。我们探讨了 OPG 与 T2DM 患者心脏迷走神经调节的关系。

方法

我们评估了接受口服降糖药（OAD）治疗的 T2DM 患者（n=42）和年龄、性别及体成分匹配的无糖尿病健康对照者（n=42）的空腹血清 OPG、高敏 C 反应蛋白（hsCRP）、血糖、胰岛素和血脂谱。记录了两组的心率变异性（HRV）频域指标和体成分。分析了 HOMA-IR 和 OPG 与各项参数的相关性。

结果

与健康对照组相比，T2DM 患者的 OPG、HOMA-IR、hsCRP、冠状动脉脂质风险因素显著增加，心脏迷走神经调节标志物（TP、SDNN、RMSSD）显著降低，提示交感神经-迷走神经失衡的低频与高频比值（LH-HF 比值）和心肌工作压力标志物 RPP 也显著升高，提示其整体 CVD 风险增加。HOMA-IR 与 RMSSD、血脂风险因素和 OPG 相关。OPG 升高与糖尿病患者的心脏迷走神经调节下降相关。OPG 升高显著降低了 TP，提示心脏迷走神经调节受损。