Department of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Department of Pediatric Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
J Diabetes Complications. 2021 May;35(5):107883. doi: 10.1016/j.jdiacomp.2021.107883. Epub 2021 Feb 6.
Cardiovascular disease (CVD) is the major cause of mortality in type 1 diabetes (T1D). Biomarkers, N-terminal pro-brain natriuretic peptide (NT-proBNP) and copeptin have been linked with measures of CVD, but their relationship in adolescents with T1D remains incompletely understood. Accordingly, we examined the associations between NT-proBNP and copeptin and hemodynamic markers of central aortic stiffness in adolescents with T1D.
In this pilot study, forty-nine pubertal adolescents with T1D (mean age 17 ± 2 years, median [Q1-Q3] Tanner Stage 5 [5, 5] and HbA1c 8.5 ± 1.5%), from the EMERALD study, were assessed for copeptin and NT-proBNP, and indices of central aortic stiffness non-invasively assessed by MRI. Pearson correlations and generalized linear regression models, adjusting for confounders, were applied to examine the relationships between biomarkers and vascular measures.
Copeptin correlated independently with both ascending aortic (AA) (β ± SE: -4.28 ± 1.87, p = 0.03) and descending aortic (DA) relative area change (RAC) (-3.41 ± 1.55, p = 0.04). NT-proBNP was independently associated with DA time-averaged wall shear stress (WSS) (0.87 ± 0.25, p = 0.001) and DA maximum wall shear stress (WSS) (2.45 ± 1.00, p = 0.02).
Serum copeptin and NT-proBNP may be associated with central aortic stiffness and elevated WSS in youth with T1D, potentially offering a non-invasive way to identify and monitor the development of early CVD in an at-risk population.
心血管疾病(CVD)是 1 型糖尿病(T1D)患者死亡的主要原因。生物标志物,N 末端脑利钠肽前体(NT-proBNP)和 copeptin 与 CVD 的测量值有关,但它们在 T1D 青少年中的关系仍不完全清楚。因此,我们研究了 T1D 青少年的 NT-proBNP 和 copeptin 与中心主动脉僵硬的血液动力学标志物之间的关系。
在这项初步研究中,我们评估了来自 EMERALD 研究的 49 名青春期 T1D 患者(平均年龄 17 ± 2 岁,中位数 [Q1-Q3] 青春期阶段 5 [5, 5] 和 HbA1c 8.5 ± 1.5%)的 copeptin 和 NT-proBNP,并通过 MRI 对中心主动脉僵硬的指数进行了非侵入性评估。应用 Pearson 相关和广义线性回归模型,调整混杂因素后,研究了生物标志物与血管测量之间的关系。
Copeptin 与升主动脉(AA)(β ± SE:-4.28 ± 1.87,p = 0.03)和降主动脉(DA)相对面积变化(RAC)(-3.41 ± 1.55,p = 0.04)独立相关。NT-proBNP 与 DA 时间平均壁切应力(WSS)(0.87 ± 0.25,p = 0.001)和 DA 最大壁切应力(WSS)(2.45 ± 1.00,p = 0.02)独立相关。
血清 copeptin 和 NT-proBNP 可能与 T1D 青少年的中心主动脉僵硬和壁切应力升高有关,这可能为识别和监测高危人群中早期 CVD 的发展提供一种非侵入性的方法。