Department of Cardiology, the Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, China.
Department of Endocrinology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, 2666 Ludang Road, Suzhou, China.
BMC Cardiovasc Disord. 2024 Nov 14;24(1):646. doi: 10.1186/s12872-024-04331-x.
To measure the plasma levels of human cartilage intermediate layer protein 1 (CILP1) in patients with diabetic cardiomyopathy (DCM), and to investigate its association with the occurrence of major adverse cardiovascular events (MACE) in DCM.
A total of 336 diabetic patients were enrolled and assigned into two groups based on the presence or absence of DCM (DCM group and N-DCM group). The baseline clinical data including glutamic-pyruvic transaminase (ALT), glutamic oxaloacetic acid transferase (AST), albumin, serum creatinine, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and N-terminal pro brain natriuretic peptide (NT-proBNP) were recorded. Subsequently, plasma levels of CILP1 at admission were detected by the enzyme linked immunosorbent assay (ELISA) method. Echocardiographic parameters were also acquired for all patients. The association of CILP1 with LVEF, LVDD and CRP was determined. In addition, the occurrence of MACE was examined during the 12-month follow-up in the DCM group.
The concentration of CILP1 in the DCM group was higher than in the N-DCM group [1329.97 (1157.14, 1494.36) ng/L vs. 789.00 (665.75, 937.06) ng/L, P < 0.05], higher in the MACE group than in the non-MACE group [1777.23 (1532.83, 2341.26)ng/L vs. 885.00 (722.40, 1224.91) ng/L, P < 0.05). Correlation analysis revealed that CILP1 expression was associated with LVEF, CRP and LVDD (r = -0.58, 0.29 and 0.44, respectively, P < 0.05). Analysis of a nomogram demonstrated that CILP1, sex, age, BMI, LVEF and LVDD could predict the occurrence of MACE in DCM patients at 12 months (P < 0.05). The plasma levels of CILP1 were independently associated with a stronger discriminating power for DCM. Furthermore, inclusion of CILP1 as a covariate in the model caused a significant improvement in risk estimation compared with traditional risk factors for DCM [BASIC: AUC: 0.556, 95%CI: 0.501-0.610; BASIC + CILP1: AUC: 0.913, 95%CI: 0.877-0.941, P < 0.05] and MACE [BASIC: AUC: 0.710, 95%CI: 0.616-0.792; BASIC + CILP1: AUC: 0.871, 95%CI: 0.794-0.928, P < 0.05].
The serum concentration of CILP1 was increased in DCM patients. Elevated fasting plasma CILP1 levels was a robust diagnostic marker of DCM and was independently associated with an increased risk of MACE.
检测糖尿病心肌病（DCM）患者血浆中人软骨中间层蛋白 1（CILP1）水平，并探讨其与 DCM 患者主要不良心血管事件（MACE）发生的关系。
共纳入 336 例糖尿病患者，根据是否存在 DCM 将其分为 DCM 组和 N-DCM 组。记录两组患者的基线临床数据，包括谷草转氨酶（ALT）、谷丙转氨酶（AST）、白蛋白、血清肌酐、糖化血红蛋白（HbA1c）、C 反应蛋白（CRP）和氨基末端脑钠肽前体（NT-proBNP）。随后采用酶联免疫吸附试验（ELISA）法检测入院时 CILP1 血浆水平。为所有患者采集超声心动图参数。确定 CILP1 与 LVEF、LVDD 和 CRP 的关系。此外，在 DCM 组中观察 12 个月随访期间 MACE 的发生情况。
DCM 组 CILP1 浓度高于 N-DCM 组[1329.97（1157.14，1494.36）ng/L 比 789.00（665.75，937.06）ng/L，P<0.05]，MACE 组高于非 MACE 组[1777.23（1532.83，2341.26）ng/L 比 885.00（722.40，1224.91）ng/L，P<0.05]。相关性分析显示，CILP1 表达与 LVEF、CRP 和 LVDD 相关（r=-0.58、0.29 和 0.44，P<0.05）。列线图分析表明，CILP1、性别、年龄、BMI、LVEF 和 LVDD 可预测 DCM 患者 12 个月时 MACE 的发生（P<0.05）。CILP1 的血浆水平与 DCM 的发生具有更强的独立相关性。此外，与 DCM 的传统危险因素相比，将 CILP1 作为协变量纳入模型可显著提高风险估计值[BASIC：AUC：0.556，95%CI：0.501-0.610；BASIC+CILP1：AUC：0.913，95%CI：0.877-0.941，P<0.05]和 MACE [BASIC：AUC：0.710，95%CI：0.616-0.792；BASIC+CILP1：AUC：0.871，95%CI：0.794-0.928，P<0.05]。
DCM 患者血清 CILP1 浓度升高。空腹 CILP1 水平升高是 DCM 的强有力诊断标志物，与 MACE 风险增加独立相关。
