2型糖尿病患者血浆TGF-β1水平及其与心脏结构和功能的关系

摘要

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-β1 in patients with type 2 diabetes mellitus,and to assess the potential association of TGF-β1 with 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-β1 were measured by means of ELISA.Cardiac index of each structure was measured by means of 2-dimensinal and M-model transtho-racic 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-β1 and 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-β1 and BNP levels were higher in the diabetes group compared with those in the control group(P<0.01 ).Multiple regression analyses re-vealed that LVMassociated with TGF-β1 levels independently(β=0.219,95%CI:0.012 -0.158,P=0.023).Conclusion:Plasmatic TGF-β1 level increased significantly in the patients with type 2 diabetes compared with the healthy people;TGF-β1 levels 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.