Department of General Practice-Family Medicine, Kharkiv National Medical University, Heroiv Kharkova Ave., 275, Kharkiv, 61106, Ukraine.
Heart Vessels. 2024 Feb;39(2):144-159. doi: 10.1007/s00380-023-02318-w. Epub 2023 Sep 27.
Catestatin (CST) is a pleiotropic peptide with cardioprotective and metabolic effects. CST is involved in the pathogenesis of both arterial hypertension (AH) and type 2 diabetes mellitus (T2DM), which are the risk factors of cardiovascular diseases. In this study, we aimed to investigate the plasma CST levels in hypertensive patients, especially with T2DM, as well as compare those with healthy volunteers, and explore the relationship between CST levels and clinical, anthropometric and laboratory parameters. 106 Hypertensive patients, 55 of which had comorbidity T2DM, and 30 healthy volunteers were enrolled in the study. All subjects underwent clinical examination, including vital signs and anthropometric data assessment, medical history interview, and blood sample collection. Plasma CST levels were measured by an enzyme-linked immunosorbent assay (ELISA), using a commercial diagnostic kit. The plasma CST levels were significantly lower in hypertensive patients (N = 106) compared with healthy subjects (N = 30) (5.02 ± 1.09 vs. 6.64 ± 0.72; p < 0.001). Furthermore, hypertensive patients with T2DM (N = 55) have significantly reduced CST levels in comparison with those without T2DM (N = 51) (4.47 ± 1.16 vs. 5.61 ± 0.61; p < 0.001). CST significantly correlated with anthropometric characteristics, in particular, weight (r = - 0.344; p < 0.001), BMI (r = - 0.42; p < 0.001), neck (r = - 0.358; p < 0.001), waist (r = - 0.487; p < 0.001), hip (r = - 0.312; p < 0.001), wrist circumferences (r = - 0.264; p = 0.002), and waist-to-hip ratio (r = - 0.395; p < 0.001). Due to its antihypertensive effect, CST has significant associations with systolic BP (r = - 0.475; p < 0.001) and duration of AH (r = - 0.26; p = 0.007). CST also has an inverse relationship with insulin (r = - 0.382; p < 0.001), glucose (r = - 0.45; p < 0.001), index HOMA-IR (r = - 0.481; p < 0.001) and HbA1c (r = - 0.525; p < 0.001), that indicate its involvement in T2DM development. Besides, CST has significant correlations with uric acid levels (r = - 0.412; p < 0.001) as well as lipid parameters, especially HDL-C (r = 0.480; p < 0.001), VLDL-C (r = - 0.238; p = 0.005), TG (r = - 0.4; p < 0.001), non-HDL-C/HDL-C (r = - 0.499; p < 0.001). Multiple linear regression analysis indicated BMI (β = - 0.22; p = 0.007), AH duration (β = - 0.25; p = 0.008), HbA1c (β = - 0.43; p = 0.019) and HDL-C levels (β = 0.27; p = 0.001) as independent predictors of CST levels. The hypertensive patients have significantly decreased CST levels that are even more reduced in the presence of comorbid T2DM. The established correlations with anthropometric and laboratory parameters indicate not only antihypertensive but also metabolic effects of CST. Our results suggest the probable role of CST in the pathophysiology of cardiometabolic diseases and the development of cardiovascular complications.
Catestatin (CST) 是一种具有心脏保护和代谢作用的多功能肽。CST 参与了动脉高血压 (AH) 和 2 型糖尿病 (T2DM) 的发病机制,而 AH 和 T2DM 是心血管疾病的风险因素。在这项研究中,我们旨在研究高血压患者,尤其是合并 T2DM 的高血压患者的血浆 CST 水平,并与健康志愿者进行比较,并探讨 CST 水平与临床、人体测量学和实验室参数之间的关系。共纳入了 106 名高血压患者,其中 55 名患有合并 T2DM,30 名健康志愿者作为对照。所有受试者均接受了临床检查,包括生命体征和人体测量数据评估、病史访谈和血液样本采集。采用酶联免疫吸附试验 (ELISA) 法,使用商业诊断试剂盒测量血浆 CST 水平。与健康对照组(N=30)相比,高血压患者(N=106)的血浆 CST 水平显著降低(5.02±1.09 比 6.64±0.72;p<0.001)。此外,与无 T2DM 的高血压患者(N=51)相比,合并 T2DM 的高血压患者(N=55)的 CST 水平显著降低(4.47±1.16 比 5.61±0.61;p<0.001)。CST 与人体测量学特征显著相关,尤其是体重(r=-0.344;p<0.001)、BMI(r=-0.42;p<0.001)、颈围(r=-0.358;p<0.001)、腰围(r=-0.487;p<0.001)、臀围(r=-0.312;p<0.001)、腕围(r=-0.264;p=0.002)和腰臀比(r=-0.395;p<0.001)。由于其降压作用,CST 与收缩压(r=-0.475;p<0.001)和 AH 持续时间(r=-0.26;p=0.007)呈显著负相关。CST 与胰岛素(r=-0.382;p<0.001)、血糖(r=-0.45;p<0.001)、HOMA-IR 指数(r=-0.481;p<0.001)和 HbA1c(r=-0.525;p<0.001)呈显著负相关,提示其参与了 T2DM 的发生发展。此外,CST 与尿酸水平(r=-0.412;p<0.001)以及血脂参数,尤其是 HDL-C(r=0.480;p<0.001)、VLDL-C(r=-0.238;p=0.005)、TG(r=-0.4;p<0.001)、非-HDL-C/HDL-C(r=-0.499;p<0.001)呈显著负相关。多元线性回归分析表明,BMI(β=-0.22;p=0.007)、AH 持续时间(β=-0.25;p=0.008)、HbA1c(β=-0.43;p=0.019)和 HDL-C 水平(β=0.27;p=0.001)是 CST 水平的独立预测因子。高血压患者的 CST 水平显著降低,合并 T2DM 的患者 CST 水平进一步降低。与人体测量学和实验室参数的相关性表明,CST 不仅具有降压作用,而且具有代谢作用。我们的研究结果表明,CST 可能在心脏代谢疾病的病理生理学和心血管并发症的发生发展中起作用。