心房钠尿肽及N末端B型利钠肽原水平与糖尿病发生的相关性研究

Relationship Between Plasma Level of Atrial N-Terminal Pro-Brain Natriuretic Peptide and Diabetes Mellitus Development

目的:研究心房钠尿肽及利钠肽原水平与糖尿病发生的相关性。方法:连续入选2009-01至2010-12到我中心进行体检的353例无糖尿病受试者及64例糖尿病患者。记录基线资料,检测其基线中段心房钠尿肽(MR-ANP)及N末端B型利钠肽原(NT-proBNP)水平。随访353例基线时无糖尿病的受试者,记录新发糖尿病。经多因素回归分析基线MR-ANP及NT-proBNP水平与糖尿病发生的关系。结果:糖尿病患者的MR-ANP及NT-proBNP水平低于无糖尿病受试者。校正其他变量后,低水平MR-ANP及NT-proBNP与糖尿病及较高的空腹血糖水平相关(P<0.05)。经过2年随访,353例基线时无糖尿病的受试者中,有58例(16.4%)新发糖尿病。多因素回归分析显示,MR-ANP水平与新发糖尿病呈负相关(OR=0.86,95%CI=0.74-0.98,P=0.03),但NT-proBNP水平与糖尿病发生不相关(OR=0.91,95%CI=0.79-1.08,P=0.27)。这两种因子水平与空腹血糖水平的升高有同样预测作用。MR-ANP水平较低能提示空腹血糖水平的升高(P<0.01),而NT-proBNP水平与空腹血糖水平升高不相关(P=0.11)。结论:糖尿病患者中,MR-ANP及NT-pro BNP水平较低;同时,基线时低水平MR-ANP能够预测糖尿病的发生及血糖升高。

Objective： To explore relationship between the levels of mid-regional atrial natriuretic peptide （MR-ANP）, NT-proBNP and diabetes mellitus （DM） development. Methods： A total of 353 subjects without DM and 64 patients with DM in our physical examination center from January 2009 to December 2010 were enrolled as Non-DM group and DM group. The plasma levels of MR-ANP and NT-proBNP were measured at the baseline for both groups and subsequently followed-up for 2 years. Multivariate regression analysis was conducted to study the relationship between MR-ANP, NT-proBN Pand DM development. Results： Compared with Non-DM group, the baseline levels of MR-ANP and NT-pro BNP was lower in DM group. With the adjusted variants, the lower levels of MR-ANP and NT-proBNP were related to DM or elevated fasting blood glucose, P〈0.05. The 2-year follow-up study presented that 58/353 （16.4%） subjects developed new-onset of DM, multivariate regression analysis indicated that MR-ANP was negatively related to DM development （OR=0.86, 95% CI： 0.74-0.98, P=0.03） and NT-proBNP was not related to DM development （OR=0.91, 95% CI： 0.79-1.08, P=0.27）. The lower level of MR-ANP may predict the elevation of fasting blood glucose, P〈0.01, while the NT-proBNP level was not related to fasting blood glucose, P=0.11. Conclusion： DM patients had lower plasma level of MR-ANP and NT-proBNP, and meanwhile, the decreased baseline level of MR-ANP may predict DM development or elevated fasting blood glucose.