The activity of circulating dipeptidyl peptidase-4 is associated with subclinical left ventricular dysfunction in patients with type 2 diabetes mellitus
The activity of circulating dipeptidyl peptidase-4 is associated with subclinical left ventricular dysfunction in patients with type 2 diabetes mellitus
复制标题
DOI：
10.1186/1475-2840-12-143
复制
发表时间：
2013-10-07
影响因子：
9.3
通讯作者：
Diez, Javier
中科院分区：
文献类型：
--
作者：
Ravassa, Susana;Barba, Joaquin;Diez, Javier
背景：2型糖尿病（T2DM）患者存在亚临床左心室收缩和/或舒张功能障碍（LVD）。二肽基肽酶-4 （DPP4）使具有心脏保护作用的肽失活。我们的目的是分析无症状T2DM患者循环DPP4的活性是否与超声心动图定义的LVD相关。方法：在这项横断面研究中，我们检查了83例无冠状动脉或瓣膜性心脏病的T2DM患者和59例年龄和性别匹配的非糖尿病受试者。酶促法测定血浆DPP4活性（DPP4a），酶联免疫吸附法测定血清氨基末端脑利钠肽前体（NT-proBNP）。通过二维超声心动图成像、靶向m型记录和多普勒超声测量评估左室功能。均数差异采用t检验和单因素方差分析。通过调整多元线性回归和逻辑回归分析评估相关性。结果：T2DM患者与非糖尿病患者相比，DPP4a升高（5855 +/- 1632 vs 5208 +/- 957 pmol/min/mL, p < 0.05）。T2DM患者的临床特征和评估左室形态的超声心动图参数在DPP4a分型中相似。然而，随着DPP4a的增加，LVD的患病率逐渐增加（13%，39%和71%，均p < 0.001）。多因素回归分析证实了DPP4a与T2DM患者LVD的独立相关性（p < 0.05）。同样，多元logistic回归分析显示，血浆DPP4a增加100 pmol/min/min与LVD频率增加独立相关，校正比值比为1.10 （95% CI, 1.04 ~ 1.15, p = 0.001）。结论：循环DPP4活性过高与T2DM患者亚临床LVD独立相关。尽管是描述性的，但这些发现表明DPP4可能参与T2DM中LVD的机制。
Background: Patients with type 2 diabetes mellitus (T2DM) present subclinical left ventricular systolic and/or diastolic dysfunction (LVD). Dipeptidyl peptidase-4 (DPP4) inactivates peptides that possess cardioprotective actions. Our aim was to analyze whether the activity of circulating DPP4 is associated with echocardiographically defined LVD in asymptomatic patients with T2DM.Methods: In this cross-sectional study, we examined 83 T2DM patients with no coronary or valve heart disease and 59 age and gender-matched non-diabetic subjects. Plasma DPP4 activity (DPP4a) was measured by enzymatic assay and serum amino-terminal pro-brain natriuretic peptide (NT-proBNP) was measured by enzyme-linked immunosorbent assay. LV function was assessed by two-dimensional echocardiographic imaging, targeted M-mode recordings and Doppler ultrasound measurements. Differences in means were assessed by t-tests and one-way ANOVA. Associations were assessed by adjusted multiple linear regression and logistic regression analyses.Results: DPP4a was increased in T2DM patients as compared with non-diabetic subjects (5855 +/- 1632 vs 5208 +/- 957 pmol/min/mL, p < 0.05). Clinical characteristics and echocardiographic parameters assessing LV morphology were similar across DPP4a tertiles in T2DM patients. However, prevalence of LVD progressively increased across incremental DPP4a tertiles (13%, 39% and 71%, all p < 0.001). Multivariate regression analysis confirmed the independent associations of DPP4a with LVD in T2DM patients (p < 0.05). Similarly, multiple logistic regression analysis showed that an increase of 100 pmol/min/min plasma DPP4a was independently associated with an increased frequency of LVD with an adjusted odds ratio of 1.10 (95% CI, 1.04 to 1.15, p = 0.001).Conclusions: An excessive activity of circulating DPP4 is independently associated with subclinical LVD in T2DM patients. Albeit descriptive, these findings suggest that DPP4 may be involved in the mechanisms of LVD in T2DM.