2型糖尿病患者血浆TGF-β_1水平及其与心脏结构和功能的关系

Plasmatic concentrations and the relationship with cardiac structure and function of TGF-β_1 in patients with type 2 diabetes mellitus

目的:检测2型糖尿病患者血浆转化生长因子-β1(TGF-β1)水平,并探讨其与心脏结构和功能之间的关系。方法:2型糖尿病患者70例作为研究组,同期50例健康体检者作为对照组,ELISA法检测血浆TGF-β1水平,利用M型超声心动图测定心脏各结构指标;脉冲多普勒技术检测二尖瓣口血流频谱,组织多普勒成像检测二尖瓣环运动频谱。比较两组各指标间差异并分析TGF-β1与各指标的相关性。结果:2型糖尿病组患者左房内径(LAD)、室间隔舒张末期厚度(IVSTd)、左室后壁舒张期厚度(LVPWTd)均比对照组患者明显增厚(P<0.01);左室质量(LVM)及左室质量指数(LVMI)明显高于对照组(P<0.01);E峰及E’较对照组明显降低(P<0.01),E/E’较对照组升高(P<0.01)。2型糖尿病组血浆TGF-β1和BNP水平均较对照组明显升高(P<0.01)。TGF-β1浓度与LVM独立相关(β=0.219,95%CI:0.012~0.158,P=0.023)。结论:2型糖尿病患者体内血浆TGF-β1水平明显升高,可作为心室重构的预测因子,为早期诊断糖尿病心肌病提供依据。

Objective: To investigate the levels of serum concentrations of TGF-β1in patients with type 2diabetes mellitus,and to assess the potential association of TGF-β1with cardiac structure and function.Methods: Seventy patients with type 2 diabetes mellitus( diabetes group),and 50 healthy participants( control group) were enrolled in this study. Circulation concentrations of TGF-β1were measured by means of ELISA. Cardiac index of each structure was measured by means of 2-dimensinal and M-model transthoracic echocardiograms. We evaluated mitral valve mouth blood flow spectrum by pulse doppler,and tissue Doppler imaging was used to measure mitral valve ring motion spectrum. Differences between the two groups were compared; and analyzed the correlation index between TGF-β1and the indicators. Results: Compared with the participants in the control group,the thickness of LAD,IVSTd,LVPWTd in patients with diabetes was significantly thicker( P < 0. 01); and the level of LVM,and LVMI was significantly higher( P < 0. 01).E peak and E’ peak in patients with diabetes was decreased( P < 0. 01),but the E / E’ ratio was higher than that in healthy participants( P < 0. 01). Plasmatic concentrations of TGF-β1and BNP levels were higher in the diabetes group compared with those in the control group( P < 0. 01). Multiple regression analyses revealed that LVM associated with TGF-β1levels independently( β = 0. 219,95% CI: 0. 012-0. 158,P =0. 023). Conclusion: Plasmatic TGF-β1level increased significantly in the patients with type 2 diabetes compared with the healthy people; TGF-β1levels in patients with type 2 diabetes might be available as pre-dictors of ventricular remodeling,to provide a new basis for early diagnosis of diabetic cardiomyopathy.