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NT-proCNP 水平可预测增殖性糖尿病视网膜病变患者的动脉粥样硬化性心血管风险更高。

NT-proCNP levels predict higher atherosclerotic cardiovascular risk profile in patients with proliferative diabetic retinopathy.

机构信息

Division of Nephrology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Fatih, 34360, Istanbul, Turkey.

Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

出版信息

Acta Diabetol. 2023 Aug;60(8):1027-1036. doi: 10.1007/s00592-023-02095-y. Epub 2023 Apr 21.

Abstract

AIMS

In this study, we aimed to demonstrate the effectiveness of serum amino-terminal proCNP (NT-proCNP) levels in predicting coronary heart disease (CHD) and cardiovascular risk in type 2 diabetes mellitus (T2DM) patients.

METHODS

We recruited 73 patients with T2DM in the study. Additionally, we grouped the patients according to their status of diabetic retinopathy (DR) as no DR, non-proliferative DR, or proliferative DR. Serum NT-proCNP levels of the patients were measured and their atherosclerotic cardiovascular disease (ASCVD) risk scores were calculated.

RESULTS

There was no significant difference in terms of NT-proCNP levels between the groups (p = 0.3) and in terms of CHD and ASCVD risk scores (p = 0.4 and p = 0.4, respectively). In the correlation analysis, a significant correlation was observed between the NT-proCNP levels and the ASCVD risk score (r = 0.373; p = 0.008 among the entire cohort and r = 0.555; p = 0.01 in the non-proliferative-DR group), smoking status (r = 0.280; p = 0.03 among the entire cohort and r = 0.362; p = 0.035 in the non-proliferative-DR group), sBP (r = 0.278; p = 0.038 among the entire cohort), and dBP (r = 0.284; p = 0.034 among the entire cohort and r = 0.482; p = 0.004 in the proliferative-DR group). In the ROC analysis, we found that the NT-proCNP level predicted a high ASCVD risk score with 83.3% sensitivity and 70.8% specificity and a very high ASCVD risk score with 100% sensitivity and 69.2% specificity among the proliferative-DR patients. No cut-off value was calculated for the prediction of high and very-high ASCVD risk scores in patients with non-proliferative DR. Similarly, no cut-off value was revealed for the prediction of established coronary artery disease in all groups.

CONCLUSIONS

Our study revealed a significant association between NT-proCNP levels and high ASCVD risk scores in patients with proliferative DR.

摘要

目的

本研究旨在证明血清氨基末端 proCNP(NT-proCNP)水平在预测 2 型糖尿病(T2DM)患者冠心病(CHD)和心血管风险方面的有效性。

方法

我们招募了 73 名 T2DM 患者进行研究。此外,我们根据患者的糖尿病视网膜病变(DR)状况将其分为无 DR、非增殖性 DR 和增殖性 DR。测量患者的血清 NT-proCNP 水平并计算其动脉粥样硬化性心血管疾病(ASCVD)风险评分。

结果

各组之间 NT-proCNP 水平无显著差异(p=0.3),CHD 和 ASCVD 风险评分也无显著差异(p=0.4 和 p=0.4)。在相关性分析中,NT-proCNP 水平与 ASCVD 风险评分之间存在显著相关性(整个队列中 r=0.373;p=0.008,非增殖性 DR 组中 r=0.555;p=0.01),与吸烟状况(整个队列中 r=0.280;p=0.03,非增殖性 DR 组中 r=0.362;p=0.035),收缩压(整个队列中 r=0.278;p=0.038)和舒张压(整个队列中 r=0.284;p=0.034)。在 ROC 分析中,我们发现 NT-proCNP 水平在增殖性 DR 患者中预测 ASCVD 高风险评分的敏感性为 83.3%,特异性为 70.8%,预测 ASCVD 极高风险评分的敏感性为 100%,特异性为 69.2%。对于非增殖性 DR 患者的 ASCVD 高风险评分和极高风险评分的预测,未计算出截断值。同样,对于所有组中已确诊的冠状动脉疾病的预测,也未揭示出截断值。

结论

我们的研究表明,在增殖性 DR 患者中,NT-proCNP 水平与 ASCVD 高风险评分之间存在显著关联。

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