合并糖尿病与黑人成年心力衰竭患者的呼吸困难严重程度及心脏代谢生物标志物相关。
Comorbid Diabetes Is Associated With Dyspnea Severity and Cardiometabolic Biomarkers in Black Adults With Heart Failure.
作者信息
Butts Brittany, Kamara Julia, Morris Alanna A, Davis Erica, Higgins Melinda K, Dunbar Sandra B
机构信息
Brittany Butts, PhD, RN, FAHA , is Assistant Professor, Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia; Julia Kamara is Undergraduate Research Assistant, Emory University College of Arts and Sciences, Atlanta, Georgia; Alanna A. Morris, MD, MSc , FAHA , is Senior Medical Director, Bayer, Atlanta, Georgia; and Erica Davis, PhD, RN , is Assistant Clinical Professor, Melinda K. Higgins, PhD , is Research Professor, and Sandra B. Dunbar, PhD, RN, FAAN, FAHA, FPCNA , is Research Professor and Charles Howard Candler Professor (Emerita), Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia.
出版信息
Nurs Res. 2025;74(1):27-36. doi: 10.1097/NNR.0000000000000784. Epub 2024 Oct 11.
BACKGROUND
Comorbidities such as Type 2 diabetes mellitus significantly and adversely influence heart failure outcomes, especially in Black adult populations. Likewise, heart failure has a negative effect on diabetes and cardiometabolic outcomes. Dyspnea, a common symptom of heart failure, often correlates with disease severity and prognosis. However, the relationship between comorbid diabetes, dyspnea severity, and cardiometabolic biomarkers in Black adults with heart failure remains understudied.
OBJECTIVES
The purpose of this pilot study was to examine differences in the distressing heart failure symptom of dyspnea and in cardiometabolic and inflammatory biomarkers in Black adults living with heart failure with and without diabetes.
METHODS
Black adults with heart failure were enrolled in this cross-sectional pilot study. Cardiometabolic and inflammatory biomarkers were measured via multiplex immunoassay. Univariate general liner models were used to identify group differences between persons with heart failure with comorbid diabetes and those without, controlling for age, sex, and comorbid burden.
RESULTS
Participants were mostly female with a mean age of 55 years and mean left ventricular ejection fraction of 33%. Participants with diabetes exhibited higher dyspnea scores compared to those without diabetes, indicating greater symptom burden. Moreover, individuals with comorbid diabetes demonstrated higher levels of cardiometabolic and inflammatory markers.
DISCUSSION
Comorbid diabetes was associated with higher dyspnea severity and adverse cardiometabolic profiles in Black adults with heart failure. These findings underscore the importance of targeted interventions addressing diabetes management and cardiometabolic risk factors to improve symptom control and outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and develop tailored therapeutic strategies for managing comorbidities in persons with heart failure, particularly in minoritized communities.
背景
2型糖尿病等合并症会对心力衰竭的预后产生重大负面影响，尤其是在成年黑人人群中。同样，心力衰竭也会对糖尿病和心脏代谢结果产生负面影响。呼吸困难是心力衰竭的常见症状，通常与疾病严重程度和预后相关。然而，合并糖尿病、呼吸困难严重程度与成年黑人心力衰竭患者心脏代谢生物标志物之间的关系仍未得到充分研究。
目的
本试点研究的目的是检查患有和未患有糖尿病的成年黑人心力衰竭患者在令人痛苦的心力衰竭症状呼吸困难以及心脏代谢和炎症生物标志物方面的差异。
方法
成年黑人心力衰竭患者参与了这项横断面试点研究。通过多重免疫测定法测量心脏代谢和炎症生物标志物。使用单变量一般线性模型来识别合并糖尿病的心力衰竭患者与未合并糖尿病的患者之间的组间差异，并控制年龄、性别和合并症负担。
结果
参与者大多为女性，平均年龄55岁，平均左心室射血分数为33%。与未患糖尿病的参与者相比，患糖尿病的参与者呼吸困难评分更高，表明症状负担更重。此外，合并糖尿病的个体心脏代谢和炎症标志物水平更高。
讨论
合并糖尿病与成年黑人心力衰竭患者更高的呼吸困难严重程度和不良心脏代谢状况相关。这些发现强调了针对性干预措施对于解决糖尿病管理和心脏代谢危险因素以改善这一高危人群的症状控制和预后的重要性。有必要进行进一步研究以阐明潜在机制，并为心力衰竭患者，特别是少数族裔社区的患者制定针对合并症的定制治疗策略。
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