Abstract:

Objective　To explore the correlations between the expression of natriuretic peptide receptor A and the levels of serum amino terminal brain natriuretic peptide precursor (NT-proBNP) and transforming growth factor (TGF)-β1 and cardiac function in patients with diabetic cardiomyopathy. Methods　A total of 120 patients with diabetic cardiomyopathy admitted to the Second Affiliated Hospital of Xi'an Medical College from May 2020 to May 2023 were retrospectively selected as a diabetic cardiomyopathy group, 70 healthy people during the same period were selected as a control group, and 50 diabetic patients receiving treatment during the same period were selected as a diabetic group. In the control group, there were 41 males and 29 females, aged (47.16±6.24) years. In the diabetic group, there were 29 males and 21 females, aged (47.62±6.56) years. In the diabetic cardiomyopathy group, there were 62 males and 58 females, aged (48.08±6.88) years. The baseline data, natriuretic peptide receptor A, NT-proBNP, TGF-β1, soluble growth stimulation expression gene 2 protein (sST2), matrix metalloproteinase-2 (MMP-2), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), left ventricular remodeling index (LVRI), left ventricular posterior wall thickness (LVPW), right ventricular end-systolic volume (RVESV), and cardiac function indicators were compared among the 3 groups. The correlations between the expression of natriuretic peptide receptor A and NT-proBNP, ventricular remodeling, TGF-β1, myocardial fibrosis, cardiac function, and lipid indexes in 120 patients with diabetic cardiomyopathy were analyzed by Pearson correlation analysis. The statistical methods used were F test and χ² test. Results　The levels of natriuretic peptide receptor A, NT-proBNP, and TGF-β1 in the diabetic cardiomyopathy group were higher than those in the control group and the diabetic group [0.72±0.21 vs. 0.32±0.17 and 0.47±0.21, (1 586.23±300.28) ng/L vs. (1 041.06±284.03) ng/L and (1 313.65±292.16) ng/L, (235.44±30.19) ng/L vs. (221.21±31.06) ng/L and (228.33±30.63) ng/L]; the levels of sST2, TIMP-1, TC, TG, LDL-C, LVRI, LVPW, RVESV, and LVEDD were higher than those in the control group and the diabetic group, while the levels of MMP-2, HDL-C, LVEF, E/A, and SV were lower than those in the control group and the diabetic group, with statistically significant differences (all P<0.05); there were statistically significant differences in the above indexes between the control group and the diabetic group (all P<0.05). Pearson correlation analysis showed that natriuretic peptide receptor A was positively correlated with the levels of NT-proBNP, TGF-β1, sST2, TIMP-1, TC, TG, LDL-C, LVRI, LVPW, RVESV, and LVEDD in patients with diabetic cardiomyopathy (r=0.432, 0.415, 0.431, 0.418, 0.441, 0.513, 0.475, 0.526, 0.548, 0.519, and 0.356, all P<0.05), was negatively correlated with the levels of MMP-2, HDL-C, LVEF, E/A, and SV (r=-0.349, -0.482, -0.342, -0.294, and -0.351, all P<0.05). Conclusion　The lower the expression of natriuretic peptide receptor A in patients with diabetic cardiomyopathy, the higher the levels of NT-proBNP and TGF-β1, and the better the cardiac function.

Key words:

 , Diabetic cardiomyopathy, Natriuretic peptide receptor A, Amino-terminal brain natriuretic peptide precursor, Transforming growth factor-β1, Cardiac function

摘要：

目的　探究利尿钠肽受体A表达与糖尿病心肌病患者血清氨基末端脑钠肽前体（NT-proBNP）、转化生长因子（TGF）-β1水平及心功能的相关性。方法　回顾性选取西安医学院第二附属医院2020年5月至2023年5月收治的120例糖尿病心肌病患者作为糖尿病心肌病组，另选70例同期体检的健康人群作为对照组、同期接受治疗的糖尿病患者50例作为糖尿病组。对照组男41例，女29例，年龄（47.16±6.24）岁。糖尿病组男29例，女21例，年龄（47.62±6.56）岁。糖尿病心肌病组男62例，女58例，年龄（48.08±6.88）岁。对比3组患者基线资料、利尿钠肽受体A、NT-proBNP、TGF-β1、可溶性生长刺激表达基因2蛋白（sST2）、基质金属蛋白酶-2（MMP-2）、基质金属蛋白酶组织抑制因子-1（TIMP-1）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、左心室重构指数（LVRI）、左心室后壁厚度（LVPW）、右心室收缩末期容积（RVESV）及心功能指标水平。利用Pearson相关性分析120例糖尿病心肌病患者利尿钠肽受体A表达与NT-proBNP、心室重构、TGF-β1、心肌纤维化、心功能、血脂指标的相关性。统计学方法采用F检验、χ²检验。结果　糖尿病心肌病组患者的利尿钠肽受体A、NT-proBNP、TGF-β1水平均高于对照组和糖尿病组［0.72±0.21比0.32±0.17、0.47±0.21，（1 586.23±300.28）ng/L比（1 041.06±284.03）ng/L、（1 313.65±292.16）ng/L，（235.44±30.19）ng/L比（221.21±31.06）ng/L、（228.33±30.63）ng/L］；sST2、TIMP-1、TC、TG、LDL-C、LVRI、LVPW、RVESV、左心室舒张末期内径（LVEDD）均高于对照组和糖尿病组，MMP-2、HDL-C、左心室射血分数（LVEF）、舒张早期峰值速度E峰/舒张晚期峰值速度A峰（E/A）、每搏心输出量（SV）均低于对照组和糖尿病组，差异均有统计学意义（均P<0.05）；糖尿病组上述指标与对照组比较，差异均有统计学意义（均P<0.05）。Pearson相关性分析结果显示，糖尿病心肌病患者的利尿钠肽受体A与NT-proBNP、TGF-β1、sST2、TIMP-1、TC、TG、LDL-C、LVRI、LVPW、RVESV、LVEDD均呈正相关（r=0.432、0.415、0.431、0.418、0.441、0.513、0.475、0.526、0.548、0.519、0.356，均P<0.05），与MMP-2、HDL-C、LVEF、E/A、SV均呈负相关（r=-0.349、-0.482、-0.342、-0.294、-0.351，均P<0.05）。结论　糖尿病心肌病患者利尿钠肽受体A表达越低，NT-proBNP、TGF-β1水平越高，心功能越好。

关键词:

糖尿病心肌病, 利尿钠肽受体A, 氨基末端脑钠肽前体, 转化生长因子-β1, 心功能