循环血栓素-2 水平与 2 型糖尿病心力衰竭住院、左心室重构和舒张功能的前瞻性关联。
Prospective associations of circulating thrombospondin-2 level with heart failure hospitalization, left ventricular remodeling and diastolic function in type 2 diabetes.
机构信息
Department of Medicine, School of Clinical Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Pok Fu Lam, Hong Kong.
出版信息
Cardiovasc Diabetol. 2022 Nov 5;21(1):231. doi: 10.1186/s12933-022-01646-x.
BACKGROUND
Circulating thrombospondin-2 (TSP2) levels were associated with the development of heart failure (HF) in recent studies. However, these studies included only a minority of patients with type 2 diabetes, which is associated with an increased HF risk. As hyperglycemia induces TSP2 expression and its tissue expression increases in type 2 diabetes, we investigated the prospective association of circulating TSP2 with incident HF hospitalization (HHF), and its associations with longitudinal changes of echocardiographic parameters in type 2 diabetes.
METHODS
Baseline serum TSP2 levels were measured in 4949 patients with type 2 diabetes to determine its association with incident HHF using multivariable Cox regression analysis. In the echocardiographic study, baseline serum TSP2 levels were measured in another 146 patients with type 2 diabetes but without cardiovascular diseases who underwent detailed transthoracic echocardiography at baseline and after 1 year.
RESULTS
Over a median follow-up of 7.8 years, 330 of 4949 patients (6.7%) developed incident HHF. Baseline serum TSP2 levels were independently associated with the development of HHF (HR 1.31, 95%CI 1.06-1.62, p = 0.014) after adjustments for baseline conventional cardiovascular risk factors, atrial fibrillation, estimated glomerular filtration rate, albuminuria and high-sensitivity C-reactive protein level, use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, loop-diuretics, aspirin, insulin, metformin and sodium-glucose co-transporter 2 inhibitors. Moreover, baseline serum TSP2 levels were independently associated with increase in average E/e' and left atrial volume index (p = 0.04 and < 0.01, respectively).
CONCLUSION
Serum TSP2 levels were independently associated with both incident HHF and deterioration in diastolic function in type 2 diabetes.
TRIAL REGISTRATION
Not Applicable.
背景
最近的研究表明，循环血栓反应蛋白-2（TSP2）水平与心力衰竭（HF）的发展有关。然而，这些研究仅包括少数 2 型糖尿病患者，而 2 型糖尿病患者 HF 风险增加。由于高血糖诱导 TSP2 表达，且其组织表达在 2 型糖尿病中增加，我们研究了循环 TSP2 与 2 型糖尿病患者事件性 HF 住院（HHF）的前瞻性关联，及其与 2 型糖尿病患者超声心动图参数的纵向变化的关联。
方法
对 4949 例 2 型糖尿病患者进行基线血清 TSP2 水平测量，以确定多变量 Cox 回归分析与事件性 HHF 的关系。在超声心动图研究中，对另外 146 例无心血管疾病的 2 型糖尿病患者进行基线血清 TSP2 水平测量，这些患者在基线和 1 年后接受了详细的经胸超声心动图检查。
结果
在中位随访 7.8 年期间，4949 例患者中有 330 例（6.7%）发生事件性 HHF。校正基线常规心血管危险因素、房颤、估计肾小球滤过率、白蛋白尿和高敏 C 反应蛋白水平、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、袢利尿剂、阿司匹林、胰岛素、二甲双胍和钠-葡萄糖共转运蛋白 2 抑制剂后，基线血清 TSP2 水平与 HHF 的发生独立相关（HR 1.31，95%CI 1.06-1.62，p=0.014）。此外，基线血清 TSP2 水平与平均 E/e'和左心房容积指数的增加独立相关（p=0.04 和 <0.01）。
结论
血清 TSP2 水平与 2 型糖尿病患者的事件性 HHF 和舒张功能恶化均独立相关。
试验注册
不适用。
Zotero 插件