Radzik Edyta, Schulz Marcin, Przywara-Chowaniec Brygida, Tomasik Andrzej
II Department of Cardiology in Zabrze, Medical University of Silesia, 10 M. Curie-Skłodowska Street, 41-800 Zabrze, Poland.
Int J Mol Sci. 2025 Aug 5;26(15):7561. doi: 10.3390/ijms26157561.
Diabetes-related pathophysiological processes contribute to endothelial dysfunction, arterial stiffening (AS), hypertension, vascular remodeling, and impaired myocardial perfusion. This study aimed to assess the relationship between arterial wall parameters and sST2 concentration as potential risk factors in type 2 diabetes (T2DM) and investigate sex-related differences. To achieve this, we enrolled 100 patients with suspected or exacerbated coronary artery disease (CAD) and divided them into a T2DM group (n = 58) and a control group (n = 42). Endothelial reactivity (lnRHI), ABI, sST2 levels, and carotid-femoral (cfPWV) and carotid-radial pulse wave velocity (crPWV) were assessed. Coronary angiography was performed in every patient, and epicardial flow and myocardial perfusion were evaluated using QuBE and FLASH. Our results showed that the coronary angiographic findings were similar in both groups. However, T2DM patients had a significantly higher central AS (cfPWV 10.8 ± 2 vs. 9.9 ± 2.7 m/s, < 0.05) and vascular age (70.0 ± 12.3 vs. 61.3 ± 15.4 years, < 0.05), while peripheral AS, RHI, and ABI showed no differences. CfPWV correlated with renal function; higher HbA1c and sST2 levels were additionally associated with advanced vascular age. Notably, central AS and vascular age were higher in men with T2DM but not in women. These findings indicate that T2DM patients exhibit increased central AS and vascular aging, influenced by sST2 levels, suggesting fibrosis as a target for precision medicine in T2DM.
糖尿病相关的病理生理过程会导致内皮功能障碍、动脉僵硬度增加（AS）、高血压、血管重塑以及心肌灌注受损。本研究旨在评估动脉壁参数与sST2浓度之间的关系，将其作为2型糖尿病（T2DM）的潜在危险因素，并研究性别差异。为实现这一目标，我们招募了100例疑似或加重冠状动脉疾病（CAD）的患者，并将他们分为T2DM组（n = 58）和对照组（n = 42）。评估了内皮反应性（lnRHI）、踝臂指数（ABI）、sST2水平以及颈股脉搏波速度（cfPWV）和颈桡脉搏波速度（crPWV）。对每位患者进行冠状动脉造影，并使用QuBE和FLASH评估心外膜血流和心肌灌注。我们的结果表明，两组的冠状动脉造影结果相似。然而，T2DM患者的中心动脉僵硬度（cfPWV为10.8±2 vs. 9.9±2.7 m/s，P<0.05）和血管年龄（70.0±12.3 vs. 61.3±15.4岁，P<0.05）显著更高，而外周动脉僵硬度、反应性充血指数（RHI）和ABI则无差异。CfPWV与肾功能相关；较高的糖化血红蛋白（HbA1c）和sST2水平还与更高的血管年龄相关。值得注意的是，T2DM男性患者的中心动脉僵硬度和血管年龄更高，而女性患者则不然。这些发现表明，T2DM患者表现出中心动脉僵硬度增加和血管老化，受sST2水平影响，提示纤维化是T2DM精准医学的一个靶点。
