2型糖尿病患者血清3-NT水平与左室舒张功能的相关性  

Association of serum 3-nitrotyrosine level with left ventricular diastolic function in type 2 diabetic patients

作　　者：龚莉 杨立佳 俞鑫[2] 荣媛媛[2] 邢明青[2] 戴红艳[2] GONG Li;YANG Li-jia;YU Xin;RONG Yuan-yuan;XING Ming-qing;DAI Hong-yan(School of Clinical Medicine,Weifang Medical University,Weifang 261000,Shandong,China;Heart Center,Qingdao Municipal Hospital,Qingdao 266000,Shandong,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261000 [2]青岛市市立医院心脏中心,山东青岛266000

出　　处：《心脏杂志》2023年第5期523-528,共6页Chinese Heart Journal

基　　金：青岛市市南区科技计划项目(2022-2-011-YY);青岛市医疗卫生优秀学科带头人计划项目(青卫科教字[2019]9号)。

摘　　要：目的探讨2型糖尿病患者血清3-硝基酪氨酸(3-nitrotyrosine,3-NT)水平与左室舒张功能的关系。方法收集并比较入选患者的一般临床资料、心脏超声指标和血清3-NT水平。采用单因素相关性分析及多元线性回归分析糖尿病组中各因素与左室舒张功能的相关性,并通过多因素Logistic回归分析血清3-NT水平与左室舒张功能的关系。结果(1)与对照组比较,糖尿病组患者收缩压、糖化血红蛋白、空腹血糖更高(P<0.01),高密度脂蛋白胆固醇更低(P<0.05),并且血清3-NT水平明显升高(P<0.01)。糖尿病组左室舒张功能各参数与对照组相比,二尖瓣瓣环间隔e’波速度(间隔e’)(P<0.05)、二尖瓣瓣环侧壁e’波速度(侧壁e’)(P<0.01)、平均e’值(P<0.01)、E/A比值(P<0.01)较低,而二尖瓣舒张期A峰、平均E/e’比值较高(P<0.01)。(2)在糖尿病组中,血清3-NT水平与间隔e’(r=-0.324,P<0.01)、侧壁e’(r=-0.360,P<0.01)呈负相关,与平均E/e’比值(r=0.565,P<0.01)呈正相关。(3)经多因素Logistic回归调整混杂因素后,血清3-NT水平是2型糖尿病患者平均E/e’比值(OR=1.034,P<0.01)、间隔e’(OR=1.026,P<0.05)及侧壁e’(OR=1.036,P<0.01)的共同独立危险因素。结论血清3-NT水平与反映左室充盈压的平均E/e’比值独立正相关,与反映左室松弛性的间隔e’、侧壁e’独立负相关,且为上述指标的独立危险因素。因此,血清3-NT水平可能成为2型糖尿病患者早期左室舒张功能异常的预测因子,为2糖尿病患者早期左室舒张功能异常的诊断提供可参考依据。AIM To investigate the relationship between serum 3-nitrotyrosine levels and left ventricular diastolic function in type 2 diabetic patients.METHODS Basic clinical data,cardiac ultrasound indexes and serum 3-NT level were compared between diabetic group and control group.In the diabetic group,the correlation between each factor and left ventricular diastolic function was analyzed by oneway correlation analysis and multiple linear regression and the association between serum 3-NT level and left ventricular diastolic function was analyzed by multivariate logistic regression.RESULTS①Compared with the control group,the systolic blood pressure,glycosylated hemoglobin and fasting blood glucose in the diabetes group were higher(P<0.01),and the high-density lipoprotein cholesterol was lower(P<0.05),and the serum 3-NT level was significantly higher(P<0.01).Compared with the control group,the parameters of left ventricular diastolic function in the diabetes group were lower in mitral annular interval e'wave velocity(interval e')(P<0.05),mitral annular lateral wall e'wave velocity(lateral wall e')(P<0.01),average e'value(P<0.01),and E/A ratio(P<0.01),while mitral diastolic peak A and average E/e'ratio were higher(P<0.01).②In the diabetes group,the serum 3-NT level was negatively correlated with the interval e'(r=−0.324,P<0.01),the lateral wall e'(r=−0.360,P<0.01),and positively correlated with the average E/e'ratio(r=0.565,P<0.01).③After adjusting for confounding factors by multivariate logistic regression,serum 3-NT level was a common independent risk factor for the average E/e'ratio(OR=1.034,P<0.01),interval e'(OR=1.026,P<0.05),and lateral wall e'(OR=1.036,P<0.01)in patients with type 2 diabetes.CONCLUSION Serum 3-NT level is independently and positively correlated with the mean E/e'ratio(which reflects left ventricular filling pressure)and was independently and negatively correlated with septal e'and lateral wall e'(which reflect left ventricular reflexivity),and it is an independent risk factor for these indic

关 键 词：血清3-硝基酪氨酸水平 2型糖尿病 左室舒张功能 

分 类 号：R587.1[医药卫生—内分泌]