2型糖尿病患者新型脂肪因子血清内脏脂肪素和内脏脂肪特异性丝氨酸蛋白酶抑制因子的表达水平与左心室肥厚的关系

目的 研究2型糖尿病(type 2 diabetes mellitus,T2DM)患者新型脂肪因子血清内脏脂肪素(visfatin)、内脏脂肪特异性丝氨酸蛋白酶抑制因子(vaspin)的表达水平与左心室肥厚(left ventricular hypertrophy,LVH)的关系。探讨影响T2DM患者发生LVH的相关因素。方法 入选93例明确诊断为T2DM患者,行超声心动图检查评估心脏结构功能,并计算左室心肌质量指数(left ventricular mass index,LVMI)。根据 LVMI 将患者分为 T2DM合并LVH 组(病例组,n=45)与T2DM不合并 LVH 组(对照组,n=48),收集患者一般情况,检测生物化学指标、血清vaspin和visfatin等指标。分析vaspin和visfatin在T2DM中表达情况与 LVH 的相关性。结果 相较于对照组,病例组的visfatin和vaspin浓度升高(4.57±2.74)ng/mL vs (3.35±2.05)ng/mL,(417.40±230.71)pg/mL vs (328.07±218.99)pg/mL,P<0.05]。Logistic多因素回归分析显示,visfatin、冠状动脉粥样硬化性心脏病、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)是T2DM合并 LVH 的独立预测因素(P<0.05)。在对visfatin与糖脂代谢相关因素分析中发现,T2DM人群中visfatin浓度与HDL-C呈负相关(P<0.05)。结论 在T2DM患者中,随着 LVMI的增加,血清visfatin浓度增加。Visfatin可能参与了T2DM发生LVH的病理过程,并与糖脂代谢紊乱相关。Visfatin可能是T2DM患者发生 LVH 的预测因素。

The relationship between the new adipokines visfatin and vaspin expression in patients with type 2 diabetes mellitus and left ventricular hypertrophy

Objective To explore the relationship between the expression of new adipokines in serum such as visfatin and vaspin,and left ventricular hypertrophy (LVH) in patients with type 2 diabetes mellitus (T2DM). We studied the related factors affecting LVH in T2DM.Methods Totally 93 patients with T2DM were enrolled, all patients were tested for biochemical indicators and blood routine indicators, echocardiography was done, the left ventricular myocardial mass index (LVMI) was calculated. According to LVMI, patients were divided into T2DM with LVH group (case group, n=45) versus T2DM without LVH group (control group, n=48), Logistic regression was used to analyze the correlation between visfatin, vaspin and LVH in T2DM patients. Results Compared with the control group, the concentrations of visfatin and vaspin in the case group were increased (4.57±2.74)ng/mL vs (3.35±2.05)ng/mL,(417.40±230.71)pg/mL vs (328.07±218.99)pg/mL], and the difference was statistically significant (P< 0.05). The results of Logistic multivariate regression analysis showed that visfatin, coronary heart disease, and high density lipoprotein-cholesterol(HDL-C)were independent predictors of T2DM combined with LVH. Further analysis of the factors related to visfatin and glucose and lipid metabolism showed that the level of visfatin was negatively correlated with HDL-C in T2DM population (P<0.05). Conclusion Serum visfatin concentrations were increased with LVMI in T2DM and associated with glycolipid metabolism disorder. Visfatin may be involved in the pathological process of developing LVH in T2DM.It may be a predictive factor for the development of LVH in patients with diabetes.