不同血压分级2型糖尿病患者血清鸢尾素与左心结构、功能的关系

Change of serum Irisin and its correlation with left cardiac structure and function in type 2 diabetes patients with different grades of blood pressure

目的研究2型糖尿病患者不同血压分级血清鸢尾素(Irisin)的变化,以及其与左心结构、功能的关系。方法收集于河北省保定市第一中心医院内分泌科住院的2型糖尿病合并高血压患者125例(糖尿病合并高血压组),单纯糖尿病患者40例(DS组),同期体检健康者35例(NS组),检测各组血清Irisin的水平,并测量受试者超声心动图参数,对比受试者之间各项指标的差异,并分析其相关性。结果与NS组相比,DS组与糖尿病合并高血压组的室间隔厚度(IVST)、左心室舒张末期内径(LVEDD)、左室后壁厚度(LVPWT)、左心房内径(LAD)及左心室质量指数(LVMI)显著增高,左心室射血分数(LVEF)、E/A、Irisin显著降低。其中高血压3级组的IVST、LVPWT、LVMI最高,LVEF、Irisin最低(P<0.05)。LVEDD随血压分级的增高而增高,而E/A降低(P<0.05)。回归分析结果显示LVEF与Irisin的表达具有相关性(P<0.05)。结论 2型糖尿病患者随着血压分级的增高左心肥厚程度相应增加,左心收缩功能随之降低,血清Irisin水平下降。Irisin可能参与2型糖尿病合并高血压患者左心结构、功能的改变。

Objective To study the change of serum Irisin and its correlation with left cardiac structure and function in type 2 diabetes mellitus(T2DM)patients with different grades of blood pressure.Methods One hundred and twenty-five inpatients with T2DM complicating hypertension(diabetes complicating hypertension group)in the endocrinology department of the Baoding Municipal First Central Hospital,40 cases of simple T2DM(DS group)and contemporaneous 35 individuals undergoing healthy physical examination(NS group)were collected.The levels of serum Irisin was detected,and the echocardiographic parameters were examined.The differences of various indexes among the subjects were compared and their correlation was analyzed.Results Compared with the NS group,the levels of IVST,LVEDD,LVPWT,LAD and LVMI in the DS group were significantly increased and the levels of LVEF,E/A and Irisin were significantly decreased(P<0.05).Among them,the levels of IVST,LVPWT and LVMI in the hypertension grade 3 group were the highest,and the levels of LVEF and Irisin were the lowest.LVEDD was increased with the rise of pressure grade,and E/A was decreased.The regression analysis results showed that LVEF had the correlation with Irisin expression(P<0.05).Conclusion The left heart hypertrophic degree in the patients with T2DM is correspondingly increased along with the rise of blood pressure grade,while the left systolic function is also decreased and serum Irisin level is lowered.Irisin might participate in the change of left cardiac structure and function in the patients with T2DM complicating hypertension.