左心房僵硬度与糖尿病前期、2 型糖尿病患者左心房功能的相关性研究

Left atrial stiffness and left atrial function in patients with prediabetes and type 2 diabetes mellitus

目的:探讨左心房僵硬度(LASI)与糖尿病前期、2型糖尿病患者左心房功能的关系。方法:收集40例健康者(正常对照组)、40例糖尿病前期患者(糖尿病前期组)和40例2型糖尿病患者(2型糖尿病组)。测量左心房容积指数、二尖瓣环速度和整体纵向峰值应变(PALS)。E/e′与PALS之比作为LASI指标。结果:与正常对照组和糖尿病前期组相比,2型糖尿病组LAVImax、LAVImin、LAVIp和LASI均增高,而PALS降低;与正常对照组比较,糖尿病前期组PALS降低,而LASI增高。3组中PALS分别与LAVImax(r=-0.369)、LAVImin(r=-0.471)、LAVIp(r=-0.471)、E/e′(r=-0.213)、TC(r=-0.241)、LDL(r=-0.365)之间呈显著负相关;LASI分别与LAVImax(r=0.495)、LAVImin(r=0.487)、LAVIp(r=0.512)、E/e′(r=0.767)和LDL(r=0.269)之间呈显著正相关。结论:与正常对照组相比,糖尿病前期、2型糖尿病患者PALS降低,LASI增高,PALS和LASI与左心房容积显著相关,LASI可以较为准确地反映糖尿病前期、2型糖尿病患者早期左心房结构、功能变化,为临床早期干预提供可靠依据。

Objective:To investigate the relationship between left atrial stiffness index(LASI)and left atrial function in patients with prediabetes and type 2 diabetes mellitus(T2DM).Methods:Forty healthy subjects were recruited as controls(normal control group).Forty 40 patients with prediabetes and another 40 with T2DM were respectively included in prediabetes group and T2DM group.All subjects underwent measurement of LASI,mitral annular velocity and peak atrial longitudinal strain(PALS).The ratio of E/e′to PALS was used as an indicator to estimate LASI.Results:Left atrial maximum volume index(LAVImax),left atrial minimum volume index(LAVImin),left atrial pre-systolic volume index(LAVIp)and LASI were generally increased,yet PALS was decreased in T2DM group compared to normal control group and prediabetes group.Reduced PALS and increased LASI were seen in patients in prediabetes group compared to those in the normal control group.PALS was negatively related to LAVImax(r=-0.369),LAVImin(r=-0.471),LAVIp(r=-0.471),E/e′(r=-0.213),TC(r=-0.241)and LDL(r=-0.365),whereas LASI was positively correlated with LAVImax(r=0.495),LAVImin(r=0.487),LAVIp(r=0.512),E/e′(r=0.767)and LDL(r=0.269)in all subjects.Conclusion:Decreased PALS,yet increased LASI was observed in patients with prediabetes and T2DM,and PALS and LASI were significantly correlated with left atrial volume.The findings suggest that LASI can be an indicator to mirror the changes of left atrial structure and function in patients with prediabetes and T2DM,and may serve as a reliable evidence for early clinical intervention in this group of patients.