生长分化因子-15与左心室舒张功能及动脉僵硬度的关系

摘要

目的:在中年体检人群中,探讨血浆生长分化因子-15(GDF-15)与左心室舒张功能及动脉僵硬度的关系.方法:于我院体检中心收集178名中年人进行横断面研究,使用标准流行病学调查表进行问卷,测量血压并测定血清空腹生化指标.用酶联免疫吸附双抗夹心法测定血浆GDF-15水平,并将受试者的血浆GDF-15按三分位数分组:一分位组(<103.96 pg/ml)、二分位组(103.96 pg/ml~121.56 pg/ml)、三分位组(>121.56 pg/ml).采用超声心动图测定左心室舒张功能、结构指标;应用VP-1000动脉硬化分析仪测定受试者臂踝脉搏波传导速度(baPWV).结果:①随着血浆GDF-15水平的升高,舒张早期心肌血流速度峰值(E)和舒张晚期血流速度峰值(A)比值(E/A)、舒张早期心肌运动速度峰值(E')均呈逐步下降(P<0.05),而E/E'与baPWV均呈逐步升高(P<0.05),差异均有统计学意义.②多元逐步线性回归分析:logGDF-15和年龄均是baPWV与E'、E/E'的独立影响因素(P<0.05);③偏相关分析:调整年龄、性别等后,baPWV与E'呈负相关(P<0.05),与E/E'呈正相关(P<0.01);按血浆GDF-15水平三分位数分组后,在三分位组中仍可得到相似的结果(P<0.05).结论:在中年体检人群中,GDF-15分别是动脉僵硬度增加和左心室舒张功能减退的独立危险因素,且GDF-15水平的升高可能影响动脉弹性和左心室舒张功能的关系.%Objective:To explore the association of growth differentiation factor-15( GDF-15 )with left ventricular diastolic function and arterial stiffness in middle-aged individuals.Methods:A total of 178 middle-aged ( 30 ~60 years )individuals from physical examination center in our hospital were randomly studied. The participants' information was collected by standard questionnaire,blood pressure and fasting blood biochemical index were also measured. GDF-15 was examined with ELISA. The participants were divided into three groups as GDF-15 < 103. 96 pg/ml,GDF-15( 103. 96 pg/ml ~ 121. 56 )pg/ml, and GDF-15> 121. 56 pg/ml. Left ventricular structure and diastolic function were measured by Color Doppler ultrasound, brachial ankle pulse wave velocity( baPWV )was determined by the full-automatic arteriosclerosis diagnostic instrument.Results:①With increased levels of GDF-15, E/A and E' decreased accordingly, E/E' and baPWV increased accordingly, P<0. 05 respectively. ②Multivariate stepwise linear regression analysis presented that log GDF-15 and age were the independent influencing factors for baPWV,E' and E/E' ,P<0. 05 respectively. ③With adjusted age and gender,baPWV was negatively related to E' ,P<0. 05,and positively related to E/E' ,P<0. 01. The similar results could also be found in three different groups all P<0. 05.Conclusion:GDF-15 was an independent risk factor for increased arterial stiffness and decreased left ventricular diastolic function,and the elevated GDF-15 may affect the relationship between arterial stiffness and left ventricular diastolic function in middle aged individuals.