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外周示波动脉性能不能描绘 2 型糖尿病患者的冠状动脉状态。

Peripheral oscillometric arterial performance does not depict coronary status in patients with type 2 diabetes mellitus.

机构信息

Herz- und Diabeteszentrum NRW, 39059Ruhr Universität Bochum, Bad Oeynhausen, Germany.

Stiftung DHD (Der herzkranke Diabetiker) Stiftung in der Deutschen Diabetes-Stiftung, Bad Oeynhausen, Germany.

出版信息

Diab Vasc Dis Res. 2021 Nov-Dec;18(6):14791641211046522. doi: 10.1177/14791641211046522.

Abstract

BACKGROUND

Arterial stiffness is associated with cardiovascular events. Matrix metalloproteases (MMPs), their tissue inhibitors (TIMPs) and galectin-3 are involved in the pathogenesis of end organ damage. This study aimed to evaluate the contribution of arterial stiffness, MMPs, TIMPs and galectin-3 with the current vascular status in type 2 diabetes mellitus (T2DM).

METHODS

74 patients with T2DM, 36 with coronary heart disease (CHD) (T2DM + CHD) and 38 without CHD (T2DM - CHD) were included. Aortic pulse wave velocity (PWVao), aortic and brachial augmentation indices (AIx aortic and AIx brachial) and central-aortic blood pressure values were determined by non-invasive arteriography. MMPs, TIMPs and galectin-3 plasma concentrations were analysed by ELISA.

RESULTS

Patients with T2DM and CHD presented with significantly increased arterial stiffness determined as AIx and significantly elevated values for TIMP-4 and galectin-3. Heterogeneous peripheral vascular status regardless of the CHD status was observed, and increasing severity of CHD was associated with an increased arterial stiffness. TIMP-4 correlated significantly with an elevated PWVao in the whole cohort independently from CHD status.

CONCLUSION

Determination of arterial stiffness is an effective and, compared to laboratory markers, more reliable method for determining the peripheral vascular situation in patients with T2DM, but it does not clearly depict coronary situation.

摘要

背景

动脉僵硬度与心血管事件有关。基质金属蛋白酶(MMPs)、其组织抑制剂(TIMPs)和半乳糖凝集素-3 参与了靶器官损伤的发病机制。本研究旨在评估动脉僵硬度、MMPs、TIMPs 和半乳糖凝集素-3 与 2 型糖尿病(T2DM)患者当前血管状况的相关性。

方法

纳入 74 例 T2DM 患者、36 例合并冠心病(CHD)的 T2DM 患者(T2DM+CHD)和 38 例不合并 CHD 的 T2DM 患者(T2DM-CHD)。通过无创动脉造影测定主动脉脉搏波速度(PWVao)、主动脉和肱动脉增强指数(AIx 主动脉和 AIx 肱动脉)以及中心动脉血压值。通过 ELISA 分析 MMPs、TIMPs 和半乳糖凝集素-3 的血浆浓度。

结果

T2DM 合并 CHD 患者的动脉僵硬度明显增加,表现为 AIx 增加,TIMP-4 和半乳糖凝集素-3 的水平显著升高。无论 CHD 状态如何,均观察到外周血管状态存在异质性,且 CHD 严重程度增加与动脉僵硬度增加相关。在整个队列中,TIMP-4 与 PWVao 的升高独立于 CHD 状态显著相关。

结论

与实验室标志物相比,动脉僵硬度的测定是一种有效且更可靠的方法,可用于评估 T2DM 患者的外周血管状况,但它并不能清楚地描述冠状动脉状况。

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Local elasticity of the aorta in patients with type 2 diabetes mellitus.2型糖尿病患者主动脉的局部弹性
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本文引用的文献

2
2. Classification and Diagnosis of Diabetes: .2. 糖尿病的分类和诊断: 。
Diabetes Care. 2020 Jan;43(Suppl 1):S14-S31. doi: 10.2337/dc20-S002.

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