2型糖尿病合并高血压患者血清分泌型卷曲相关蛋白5水平与血压分级及左心室肥大的关系

Correlation between serum sfrp5 and left ventricular hypertrophy in patients with T2DM complicated with different classifications of hypertension

目的探讨2型糖尿病合并不同分级高血压患者血清分泌型卷曲相关蛋白5(sfrp5)的水平变化及其与左心室肥大的关系。方法将200例受试者分为健康对照组(NC组)、单纯糖尿病组(DS组)、糖尿病合并高血压1级组(H1组)、糖尿病合并高血压2级组(H2组)、糖尿病合并高血压3级组(H3组),采用酶联免疫吸附法检测各组血清sfrp5水平,超声心动图观察各组心脏结构及功能的变化。结果 DS、H1、H2、H3组二尖瓣口舒张早期及舒张晚期血流峰值速度比(E/A)及血清sfrp5水平较NC组降低(P均<0.05);H1、H2、H3组E/A及血清sfrp5水平低于DS组,并随着血压分级的增高,E/A及血清sfrp5水平逐渐降低(P均<0.05)。DS、H1、H2、H3组左心室质量指数(LVMI)较NC组增大(P均<0.05);H1、H2、H3组LVMI大于DS组,并随着血压分级的增高,LVMI逐渐增大(P均<0.05)。多元线性回归分析显示血清sfrp5水平与LVMI、SBP、DBP呈负相关(r分别为-0.260、-0.160、-0.290,P均<0.05)。结论 2型糖尿病患者随着血压分级的增高血清sfrp5水平逐渐下降,左心室肥大的程度逐渐加重。血清sfrp5水平变化与2型糖尿病合并高血压患者左心室肥大改变相关。

Objective To investigate the changes of serum secreted frizzled-related protein-5（ sfrp5） and its correlation with left ventricular hypertrophy in patients with type 2 diabetes mellitus（ T2 DM） and different classifications of hypertension.Methods A total of 200 subjects were divided into the normal control group（ NC group）,T2 DM without hypertension group（ DS group）,T2 DM with grade 1 hypertension group（ H1 group）,T2 DM with grade 2 hypertension group（ H2 group）,and T2 DM with grade 3 hypertension group（ H3 group）. We determined the levels of serum sfrp5 and used the echocardiogram to observe the changes of cardiac structure and function in each group. Results The early diastolic and late diastolic peak velocity ratio（ E/A） and sfrp5 decreased in the DS,H1,H2,and H3 groups as compared with that of the NC group（ both P〈0. 05）.E/A and sfrp5 were significantly lower in the H1,H2,and H3 groups than in the DS group,and gradually decreased with the increase of blood pressure classification（ both P〈0. 05）. The left ventricular mass index（ LVMI） was higher in the DS,H1,H2,and H3 groups than in the NC group（ all P〈0. 05）. The LVMI in the H1,H2,and H3 groups were greater than that in the DS group,and the LVMI gradually increased with the increase of blood pressure（ all P〈0. 05）. Multiple linear regression analysis showed that serum sfrp5 level was negatively correlated with LVMI,SBP,and DBP（ r =-0. 260,-0. 160,-0. 290; P〈0. 05）.Conclusions With the increase of blood pressure classification,the serum sfrp5 decreases but the LVMI increases. Sfrp5 plays an important role in the change of left ventricular hypertrophy in patients with T2 DM and hypertension.