Bahrami Hashmat Sayed Zohori, Jørgensen Peter Godsk, Hove Jens Dahlgaard, Dixen Ulrik, Rasmussen Line Jee Hartmann, Eugen-Olsen Jesper, Rossing Peter, Jensen Magnus T
Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; Department of Cardiology, Copenhagen University Hospital, Amager & Hvidovre, Kettegård Alle 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3b, 2200 Copenhagen, Denmark.
Department of Cardiology, Copenhagen University Hospital, Herlev & Gentofte, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark.
Diabetes Res Clin Pract. 2025 Apr;222:112071. doi: 10.1016/j.diabres.2025.112071. Epub 2025 Mar 3.
To investigate the association between chronic inflammation and subclinical left ventricular dysfunction in type 1 diabetes (T1D).
In a cross-sectional study of individuals with T1D without known heart disease, interleukin-6 (IL-6), soluble-urokinase-plasminogen-activator-receptor (suPAR), and high-sensitivity C-reactive-protein (hsCRP) were examined for associations with echocardiographic E/e' (primary outcome) and global longitudinal strain (GLS) (secondary outcome). We adjusted for several clinical variables in linear regression analysis, including N-terminal pro-B-type natriuretic peptide (NT-proBNP). The biomarkers were categorized as elevated/non-elevated based on their upper quartiles.
Of 962 individuals (52 % male, mean age 49 ± 14 years), mean E/e' was 7 ± 3 and GLS 18 ± 3. In fully adjusted models, all biomarkers were each associated with increased E/e': beta coefficients for IL-6 0.2 (95 % confidence intervals: 0.1-0.3, P = 0.001), suPAR 0.5 (0.1-0.7, P = 0.011), and hsCRP 0.1 (0.0-0.2, P = 0.023). Combining biomarkers showed stronger associations: elevated IL-6 and suPAR 1.3 (0.7-2.0, P < 0.001), elevated all three 1.9 (1.1-2.7, P < 0.001). Results were similar for decreased GLS with IL-6-0.4 (-0.7 to 0.0, P = 0.039), IL-6 and hsCRP -1.0 (-1.7 to -0.4, P = 0.007), all three -1.1 (-2.0 to -0.3, P = 0.009).
Inflammatory biomarkers are independently associated with subclinical left ventricular dysfunction. Chronic inflammation may contribute to the development of myocardial dysfunction in T1D.
研究1型糖尿病（T1D）患者慢性炎症与亚临床左心室功能障碍之间的关联。
在一项针对无已知心脏病的T1D患者的横断面研究中，检测白细胞介素-6（IL-6）、可溶性尿激酶型纤溶酶原激活物受体（suPAR）和高敏C反应蛋白（hsCRP）与超声心动图E/e'（主要结局）和整体纵向应变（GLS）（次要结局）之间的关联。我们在线性回归分析中对包括N末端B型利钠肽原（NT-proBNP）在内的多个临床变量进行了校正。根据生物标志物的上四分位数将其分类为升高/未升高。
在962名个体（52%为男性，平均年龄49±14岁）中，平均E/e'为7±3，GLS为18±3。在完全校正模型中，所有生物标志物均与E/e'升高相关：IL-6的β系数为0.2（95%置信区间：0.1-0.3，P=0.001），suPAR为0.5（0.1-0.7，P=0.011），hsCRP为0.1（0.0-0.2，P=0.023）。联合生物标志物显示出更强的关联：IL-6和suPAR升高为1.3（0.7-2.0，P<0.001），三者均升高为1.9（1.1-2.7，P<0.001）。对于GLS降低，结果相似：IL-6为-0.4（-0.7至0.0，P=0.039），IL-6和hsCRP为-1.0（-1.7至-0.4，P=0.007），三者均为-1.1（-2.0至-0.3，P=0.009）。
炎症生物标志物与亚临床左心室功能障碍独立相关。慢性炎症可能促成T1D患者心肌功能障碍的发生。
