Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
School of Mathematics and Actuarial Science, University of Leicester, Leicester, UK.
Diabet Med. 2022 Aug;39(8):e14884. doi: 10.1111/dme.14884. Epub 2022 Jun 16.
To investigate the relationship between fibro-inflammatory biomarkers and cardiovascular structure/function in people with Type 2 Diabetes (T2D) compared to healthy controls and the effect of two lifestyle interventions in T2D.
Data were derived from the DIASTOLIC randomised controlled trial (RCT) and includes a comparison between those with T2D and the matched healthy volunteers recruited at baseline. Adults with T2D without cardiovascular disease (CVD) were randomized to a 12-week intervention either: (1) exercise training, (2) a low-energy (∼810 kcal/day) meal-replacement plan (MRP) or (3) standard care. Principal Component and Fisher's linear discriminant analysis were used to investigate the relationships between MRI acquired cardiovascular outcomes and fibro-inflammatory biomarkers in cases versus controls and pre- and post-intervention in T2D.
At baseline, 83 people with T2D (mean age 50.5 ± 6.4; 58% male) and 36 healthy controls (mean age 48.6 ± 6.2; 53% male) were compared and 76 people with T2D completed the RCT for pre- post-analysis. Compared to healthy controls, subjects with T2D had adverse cardiovascular remodelling and a fibro-inflammatory profile (20 differentially expressed biomarkers). The 3D data visualisations showed almost complete separation between healthy controls and those with T2D, and a marked shift towards healthy controls following the MRP (15 biomarkers significantly changed) but not exercise training.
Fibro-inflammatory pathways and cardiovascular structure/function are adversely altered before the onset of symptomatic CVD in middle-aged adults with T2D. The MRP improved the fibro-inflammatory profile of people with T2D towards a more healthy status. Long-term studies are required to assess whether these changes lead to continued reverse cardiac remodelling and prevent CVD.
研究 2 型糖尿病（T2D）患者与健康对照者之间纤维炎症生物标志物与心血管结构/功能的关系，以及两种生活方式干预对 T2D 的影响。
数据来自 DIASTOLIC 随机对照试验（RCT），包括 T2D 患者与基线时招募的匹配健康志愿者的比较。无心血管疾病（CVD）的 T2D 成年人随机分为 12 周干预组：（1）运动训练，（2）低能量（约 810 kcal/天）代餐计划（MRP）或（3）标准护理。主成分和 Fisher 线性判别分析用于研究 MRI 获得的心血管结局与病例与对照组以及 T2D 患者干预前后纤维炎症生物标志物之间的关系。
基线时，83 名 T2D 患者（平均年龄 50.5±6.4；58%为男性）和 36 名健康对照者（平均年龄 48.6±6.2；53%为男性）进行了比较，76 名 T2D 患者完成了 RCT 的预-后分析。与健康对照组相比，T2D 患者存在心血管重构不良和纤维炎症特征（20 种差异表达生物标志物）。3D 数据可视化显示，健康对照组和 T2D 患者之间几乎完全分离，MRP 后明显向健康对照组转移（15 种生物标志物显著改变），而运动训练则不然。
在中年 T2D 患者出现有症状 CVD 之前，纤维炎症途径和心血管结构/功能就已经发生了不良改变。MRP 改善了 T2D 患者的纤维炎症特征，使其更接近健康状态。需要进行长期研究，以评估这些变化是否导致持续的心脏逆重构并预防 CVD。
