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确定N末端脑钠肽前体(NT-proBNP)水平在糖尿病心力衰竭患者中的作用:一项来自印度北部的研究。

Determining the role of NT-proBNP levels in diabetic patients with heart failure: A study from North India.

作者信息

Siddiqui Merajul H, Dixit Ritvija, Agarwal Shikha, Jha Subhash Chandra, Khanna Harshita, Agrawal Sonu Kumari

机构信息

Department of Biochemistry, Saraswathi Medical Institute, Hapur, Uttar Pradesh, India.

Kasturba Gandhi Medical College, Manipal, Karnataka, India.

出版信息

J Educ Health Promot. 2024 Feb 7;13:20. doi: 10.4103/jehp.jehp_701_23. eCollection 2024.

Abstract

BACKGROUND

Diabetic patients are at higher risk of cardiovascular morbidity and mortality. NT-proBNP levels measurements are useful for the assessment of risk in heart failure patients in emergency condition and give the faster result. Further, it also offers lower cost and unnecessary hospitalization and follow-up cost. The studies have shown that NT-proBNP levels are a direct predictor of outcome risk in diabetic patients with heart failure. The objective of this research was to study the role of NT-proBNP levels to determine the severity of heart failure in diabetic patients.

MATERIALS AND METHODS

In this study 150 patients diagnosed with symptomatic heart failure admitted to the emergency department of a tertiary care center from January 2021 to January 2022 have been included in Saraswati Institute Of Medical Sciences, Hapur, India. N-terminal pro-B-type natriuretic peptide (NT-Pro-BNP) levels were measured using an automated analyzer ranging between 60 and 3000 pg/ml. According to the European society of cardiology (ESC) guidelines, it has been defined as NT-Pro-BNP level above 125 pg/ml indicates a high possibility of heart failure and NT-Pro-BNP level below 125 pg/ml excludes the high possibility of heart failure. All the patients underwent an echocardiographic study and ejection fraction was calculated and recorded.

RESULTS

In diabetic patients ejection fraction was significantly lower in diabetic patients: 47.15 ± 8.75% vs. 43.24 ± 9.54%, = 0.002). We have observed statistically significant lower HDL values (40.10 ± vs. 35.94 mg/dL, = 0.0004), however, significant higher triglycerides values were found (101.43 ± 41.7 mg/dL vs. 151.37 ± 78.85, = 0.001). No significant difference was observed in LDL level (97.8 ± 31.23 vs. 92.35 ± 314.2, ≥ 0.05) and total cholesterol level (161.49 ± 41.38 vs. 159.97 ± 41.12, ≥ 0.05).

CONCLUSION

We concluded that the measurement of NT-proBNP in heart failure and diabetic patients could be an economic marker for the evaluation of morbidity and mortality, facilitating better management and follow-up.

摘要

背景

糖尿病患者发生心血管疾病和死亡的风险更高。N末端B型利钠肽原(NT-proBNP)水平测量对于评估急诊心力衰竭患者的风险很有用,且结果得出更快。此外,它还能降低成本以及不必要的住院和后续随访成本。研究表明,NT-proBNP水平是糖尿病合并心力衰竭患者预后风险的直接预测指标。本研究的目的是探讨NT-proBNP水平在确定糖尿病患者心力衰竭严重程度中的作用。

材料与方法

本研究纳入了2021年1月至2022年1月期间在印度哈普尔市萨拉斯瓦蒂医学科学研究所三级医疗中心急诊科收治的150例诊断为有症状心力衰竭的患者。使用自动分析仪测量N末端B型利钠肽原(NT-Pro-BNP)水平,范围在60至3000 pg/ml之间。根据欧洲心脏病学会(ESC)指南,NT-Pro-BNP水平高于125 pg/ml表明心力衰竭可能性高,NT-Pro-BNP水平低于125 pg/ml则排除心力衰竭的高可能性。所有患者均接受了超声心动图检查,并计算和记录射血分数。

结果

糖尿病患者的射血分数显著更低:分别为47.15±8.75%和43.24±9.54%,P = 0.002)。我们观察到糖尿病患者的高密度脂蛋白(HDL)值在统计学上显著更低(40.10± 与35.94 mg/dL,P = 0.0004),然而,甘油三酯值显著更高(101.43±41.7 mg/dL与151.37±78.85,P = 0.001)。低密度脂蛋白(LDL)水平(97.8±31.23与92.35±314.2,P≥0.05)和总胆固醇水平(161.49±41.38与159.97±41.12,P≥0.05)未观察到显著差异。

结论

我们得出结论,测量心力衰竭和糖尿病患者的NT-proBNP水平可能是评估发病率和死亡率的一个经济指标,有助于更好地管理和随访。

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