Department of Cardiology, Hyogo Prefectural Awaji Medical Center.
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine.
Circ J. 2023 Dec 25;88(1):110-116. doi: 10.1253/circj.CJ-23-0577. Epub 2023 Nov 14.
Diabetes increases the risk of heart failure (HF). 3-Hydroxyisobutyric acid (3-HIB) is a muscle-derived metabolite reflecting systemic insulin resistance. In this study, we investigated the prognostic impact of 3-HIB in patients with chronic HF.
The KUNIUMI Registry chronic cohort is a community-based cohort study of chronic HF in Awaji Island, Japan. We analyzed the association between serum 3-HIB concentrations and adverse cardiovascular (CV) events in 784 patients from this cohort. Serum 3-HIB concentrations were significantly higher in patients with than without diabetes (P=0.0229) and were positively correlated with several metabolic parameters. According to Kaplan-Meier analysis, rates of CV death and HF hospitalization at 2 years were significantly higher among HF patients without diabetes in the high 3-HIB group (3-HIB concentrations above the median; i.e., >11.30 μmol/L) than in the low 3-HIB group (log-rank P=0.0151 and P=0.0344, respectively). Multivariable Cox proportional hazard models adjusted for established risk factors for HF revealed high 3-HIB as an independent predictor of CV death (hazard ratio [HR] 1.82; 95% confidence interval [CI] 1.16-2.85; P=0.009) and HF hospitalization (HR 1.72; 95% CI 1.17-2.53, P=0.006) in HF patients without diabetes, whereas no such trend was seen in subjects with diabetes.
In a community cohort, circulating 3-HIB concentrations were associated with prognosis in chronic HF patients without diabetes.
糖尿病会增加心力衰竭（HF）的风险。3-羟基异丁酸（3-HIB）是一种反映全身胰岛素抵抗的肌肉衍生代谢物。在这项研究中，我们研究了 3-HIB 在慢性 HF 患者中的预后影响。
KUNIUMI 登记册慢性队列是日本淡路岛的一项基于社区的慢性 HF 队列研究。我们分析了该队列中 784 例患者的血清 3-HIB 浓度与不良心血管（CV）事件之间的关联。患有糖尿病的患者的血清 3-HIB 浓度明显高于无糖尿病患者（P=0.0229），并且与多种代谢参数呈正相关。根据 Kaplan-Meier 分析，无糖尿病 HF 患者中，2 年时 CV 死亡和 HF 住院的发生率在高 3-HIB 组（3-HIB 浓度高于中位数；即，>11.30μmol/L）显著高于低 3-HIB 组（log-rank P=0.0151 和 P=0.0344，分别）。调整 HF 既定危险因素的多变量 Cox 比例风险模型显示，高 3-HIB 是无糖尿病 HF 患者 CV 死亡（危险比 [HR] 1.82；95%置信区间 [CI] 1.16-2.85；P=0.009）和 HF 住院（HR 1.72；95% CI 1.17-2.53，P=0.006）的独立预测因素，而在患有糖尿病的患者中则没有这种趋势。
在社区队列中，循环 3-HIB 浓度与无糖尿病慢性 HF 患者的预后相关。
