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慢性心力衰竭恶病质患者中36T/C多态性的临床意义

Clinical Significance of 36T/C Polymorphism in Cachectic Patients with Chronic Heart Failure.

作者信息

Sobieszek Grzegorz, Powrózek Tomasz, Skwarek-Dziekanowska Aneta, Małecka-Massalska Teresa

机构信息

Department of Cardiology, 1st Military Clinical Hospital with the Outpatient Clinic, 20-080 Lublin, Poland.

Department of Human Physiology, Medical University of Lublin, 20-059 Lublin, Poland.

出版信息

J Clin Med. 2021 Mar 5;10(5):1095. doi: 10.3390/jcm10051095.

Abstract

One of the main factors contributing to the development of nutritional deficits in chronic heart failure (CHF) patients is the systemic inflammatory process. Progressing inflammatory response leads to exacerbation of the disease and could develop into cardiac cachexia (CC), characterized by involuntary weight loss followed by muscle wasting. The aim of this study was to assess the relationship between rs767455 (36 T/C) of the and the occurrence of nutritional disorders in CHF patients with cachexia. We enrolled 142 CHF individuals who underwent cardiac and nutritional screening in order to assess cardiac performance and nutritional status. The relationship between rs767455 genotypes and patients' features was investigated. A greater distribution of the TT genotype among cachectic patients in contrast to non-cachectic individuals was found (TT frequencies of 62.9% and 37.1%, respectively; = 0.013). We noted a significantly lower albumin concentration ( = 0.039) and higher C-reactive protein (CRP) levels ( = 0.019) in patients with the TT genotype. Regarding cardiac parameters, CHF individuals bearing the TT genotype demonstrated a significant reduction in ejection fraction (EF) ( = 0.033) in contrast to other genotype carriers; moreover, they had a significantly higher concentration of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the blood ( = 0.018). We also noted a lower frequency of TT genotype carriers among individuals qualified as grades I or II of the New York Heart Association (NYHA) ( = 0.006). The multivariable analysis selected the TT genotype as an unfavorable factor related to a higher chance of cachexia in CHF patients (Odds ratio (OR) = 2.56; = 0.036). The rs767455TT genotype of can be considered as an unfavorable factor related to a higher risk of cachexia in CHF patients.

摘要

导致慢性心力衰竭(CHF)患者出现营养缺乏的主要因素之一是全身炎症过程。不断进展的炎症反应会导致疾病恶化,并可能发展为心源性恶病质(CC),其特征是体重不由自主减轻,随后出现肌肉萎缩。本研究的目的是评估 的 rs767455(36 T/C)与伴有恶病质的CHF患者营养障碍发生之间的关系。我们招募了142名接受心脏和营养筛查以评估心脏功能和营养状况的CHF患者。研究了rs767455基因型与患者特征之间的关系。与非恶病质个体相比,发现恶病质患者中TT基因型的分布更多(TT频率分别为62.9%和37.1%; = 0.013)。我们注意到TT基因型患者的白蛋白浓度显著降低( = 0.039),C反应蛋白(CRP)水平更高( = 0.019)。关于心脏参数,与其他基因型携带者相比,携带TT基因型的CHF个体的射血分数(EF)显著降低( = 0.033);此外,他们血液中的脑钠肽N末端前体激素(NT-proBNP)浓度显著更高( = 0.018)。我们还注意到,在纽约心脏协会(NYHA)I级或II级的个体中,TT基因型携带者的频率较低( = 0.006)。多变量分析选择TT基因型作为与CHF患者发生恶病质几率较高相关的不利因素(比值比(OR) = 2.56; = 0.036)。 的rs767455TT基因型可被视为与CHF患者发生恶病质风险较高相关的不利因素。

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