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单核细胞/高密度脂蛋白胆固醇比值与 2 型糖尿病患者的亚临床左心重构和功能障碍相关。

Monocyte to High-Density Lipoprotein Cholesterol Ratio Is Associated with Subclinical Left Cardiac Remodeling and Dysfunction in Type 2 Diabetes Mellitus.

机构信息

Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University.

Department of Cardiovascular Medicine, The Third Affiliated Hospital of Sun Yat-sen University.

出版信息

Int Heart J. 2022 May 31;63(3):524-530. doi: 10.1536/ihj.21-681. Epub 2022 May 14.

Abstract

Chronic inflammation is involved in the development of heart failure (HF) in type 2 diabetes mellitus (T2DM). However, reliable and easily accessible biomarker of subclinical left cardiac remodeling and dysfunction remains a challenge.Overall, 1020 patients with T2DM without overt HF were enrolled from May 2019 to April 2020. Monocyte to high-density lipoprotein ratio (MHR) was calculated by blood monocyte count divided by high-density lipoprotein cholesterol. Left cardiac structure and function were assessed using transthoracic echocardiography. Univariate and multivariate linear regression analyses were used to estimate the association of MHR (Lg transferred) with echocardiographic parameters. We found that septal wall thickness (SWT), left ventricular internal end-diastole dimension (LVIDd), and left ventricular mass index (LVMI) raised with increasing MHR (P = 0.002 for SWT, P < 0.001 for LVIDd, and P = 0.001 for LVMI). Declined trends were shown in ejection fraction (EF) (P = 0.016), E velocity (P = 0.037), E/A ratio (P = 0.009), and tissue Doppler e' (P < 0.001), and elevating trend was observed in E/e' (P < 0.001). In multivariate regression analysis, MHR (Lg transferred) was positively associated with LVIDd (β = 0.031; P = 0.016), LVMI (β = 0.073; P = 0.014), and E/e' (β = 0.331; P < 0.001), whereas it was negatively associated with EF (β = -0.086; P = 0.007), E/A (β = -0.072; P = 0.009), and e' (β = -0.332; P < 0.001).MHR could be a practical biomarker for indicating subclinical cardiac remodeling and dysfunction in T2DM, due to low cost and easy availability.

摘要

慢性炎症参与了 2 型糖尿病(T2DM)患者心力衰竭(HF)的发生发展。然而,可靠且易于获取的亚临床左心重构和功能障碍的生物标志物仍然是一个挑战。

本研究共纳入了 1020 例无明显 HF 的 T2DM 患者,这些患者均于 2019 年 5 月至 2020 年 4 月期间入组。单核细胞/高密度脂蛋白比值(MHR)通过血单核细胞计数除以高密度脂蛋白胆固醇计算得出。采用经胸超声心动图评估左心结构和功能。采用单变量和多变量线性回归分析来评估 MHR(Lg 转换)与超声心动图参数的相关性。结果显示,随着 MHR 的升高,室间隔厚度(SWT)、左心室舒张末期内径(LVIDd)和左心室质量指数(LVMI)逐渐增加(SWT:P = 0.002;LVIDd:P < 0.001;LVMI:P = 0.001)。射血分数(EF)(P = 0.016)、E 速度(P = 0.037)、E/A 比值(P = 0.009)和组织多普勒 e'(P < 0.001)呈下降趋势,E/e'呈上升趋势(P < 0.001)。多变量回归分析显示,MHR(Lg 转换)与 LVIDd(β = 0.031;P = 0.016)、LVMI(β = 0.073;P = 0.014)和 E/e'(β = 0.331;P < 0.001)呈正相关,而与 EF(β = -0.086;P = 0.007)、E/A(β = -0.072;P = 0.009)和 e'(β = -0.332;P < 0.001)呈负相关。MHR 可能是 T2DM 患者亚临床左心重构和功能障碍的一种实用的生物标志物,因为其成本低且易于获取。

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