Could Ghrelin Expression Regulate Diastolic Cardiac Function in Type 2 Diabetic Obese Patients?

作者信息

Sardu Celestino, D'Onofrio Nunzia, Trotta Maria Consiglia, Balestrieri Maria Luisa, Nicoletti Giovanni Francesco, D'Amico Giovanbattista, Fumagalli Carlo, Contaldi Carla, Pacileo Giuseppe, Scisciola Lucia, Nicoletti Maddalena, Marfella Ludovica Vittoria, Sbriscia Matilde, Sasso Ferdinando Carlo, Signoriello Giuseppe, Paolisso Giuseppe, Marfella Raffaele

机构信息

Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.

Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

出版信息

Diabetes Metab Res Rev. 2025 May;41(4):e70049. doi: 10.1002/dmrr.70049.

DOI:10.1002/dmrr.70049

PMID:40323144

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12051781/

Abstract

AIMS

Adipose tissue expresses cytokines, sirtuin-1 (SIRT1), and microRNAs (miRs), regulating left ventricle (LV)-diastolic function (LV-DF). Ghrelin could modulate these pathways in patients with type 2 diabetes mellitus (T2DM) and obesity. We investigated ghrelin expression in T2DM obese patients after abdominal fat excision, and in those with LV-DF normalisation at 1 year of follow-up.

MATERIALS AND METHODS

Two-hundred and two T2DM obese patients enroled for abdominoplastic surgery were divided into those with normal LV-DF (group 1: E/E' < 9, n 76) and those with altered LV-DF: group 2 (9 < E/E' < 14; n 96) and group 3 (E/E' > 14, n 28).

RESULTS

Patients with LV-diastolic dysfunction had over-inflammation, lower SIRT1 and higher abdominal fat sodium-glucose-transporter-two (SGLT2) expression (p < 0.05). They did not differ for ghrelin expression (p > 0.05). They evidenced different tissue/serum expression of miR-21, miR-92 and miR-126 (p < 0.05). Group 2 versus group 1 over-expressed tissue inflammatory markers and SGLT2 (p < 0.05), with higher extent in group 3 versus group 1 (p < 0.01) and versus group 2 (p < 0.025). SIRT1 was downregulated in group 2 versus group 1 (p < 0.05), and versus group 3 (p < 0.01). At the follow-up end, patients with lower LV-diastolic dysfunction had lower inflammation and SGLT2, and higher serum ghrelin (p < 0.05). They increased miR-126, and reduced serum miR-21 and miR-92 expression. At the follow-up end, 50 patients experienced LV-DF normalisation, which was predicted by tissue miR-126 (HR 1.344, CI 95% 1.126-1.937), and ghrelin (HR 1.123, CI 95% 1.016-1.310).

CONCLUSIONS

In T2DM obese patients, abdominal fat excision could reduce inflammation, up-regulating serum ghrelin and inducing miRs implied in LV-DF normalisation at 1 year of follow-up.