Impact of the Remission of Type 2 Diabetes on Cardiovascular Structure and Function, Exercise Capacity and Risk Profile: A Propensity Matched Analysis.
Impact of the Remission of Type 2 Diabetes on Cardiovascular Structure and Function, Exercise Capacity and Risk Profile: A Propensity Matched Analysis.
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DOI：
10.3390/jcdd10050191
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发表时间：
2023-04-24
影响因子：
2.4
通讯作者：
Brady EM
中科院分区：
文献类型：
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作者：
Bilak JM;Yeo JL;Gulsin GS;Marsh AM;Sian M;Dattani A;Ayton SL;Parke KS;Bain M;Pang W;Boulos S;Pierre TGS;Davies MJ;Yates T;McCann GP;Brady EM
2型糖尿病（T2 D）具有心力衰竭的高风险，在症状发作前经常伴有心血管结构和功能异常的证据。T2 D缓解对心血管结构和功能的影响尚不清楚。描述了T2 D缓解对心血管结构和功能以及运动能力的影响，超出了体重减轻和高血压。无心血管疾病的T2 D成人患者接受了多模态心血管成像、心肺运动试验和心脏代谢分析。T2 D缓解病例（糖化血红蛋白（HbA 1c）< 6.5%，未接受降糖治疗，≥3个月）的倾向评分基于年龄、性别、种族和暴露时间与活动性T2 D患者（n = 100）（最近邻法）和非T2 D对照（n = 25）（1：1）匹配。与活动性T2 D相比，T2 D缓解与较低的瘦素-脂联素比率、肝脂肪变性和甘油三酯、更大的运动能力和显著较低的分钟通气量/二氧化碳产生量（VE/VCO 2斜率）相关（27.74 ± 3.95 vs. 30.52 ± 5.46，p < 0.0025）。与对照组相比，T2 D缓解组仍存在向心性重构的证据（左心室质量/体积比0.88 ± 0.10 vs. 0.80 ± 0.10，p < 0.025）。T2 D缓解与代谢风险特征改善和对运动的缓解反应相关，而不伴随心血管结构或功能的改善。需要持续关注这一重要患者人群的风险因素控制。
Type 2 diabetes (T2D) confers a high risk of heart failure frequently with evidence of cardiovascular structural and functional abnormalities before symptom onset. The effects of remission of T2D on cardiovascular structure and function are unknown. The impact of the remission of T2D, beyond weight loss and glycaemia, on cardiovascular structure and function and exercise capacity is described. Adults with T2D without cardiovascular disease underwent multimodality cardiovascular imaging, cardiopulmonary exercise testing and cardiometabolic profiling. T2D remission cases (Glycated hemoglobin (HbA1c) < 6.5% without glucose-lowering therapy, ≥3 months) were propensity score matched 1:4 based on age, sex, ethnicity and time of exposure to those with active T2D (n = 100) with the nearest-neighbour method and 1:1 with non-T2D controls (n = 25). T2D remission was associated with a lower leptin–adiponectin ratio, hepatic steatosis and triglycerides, a trend towards greater exercise capacity and significantly lower minute ventilation/carbon dioxide production (VE/VCO2 slope) vs. active T2D (27.74 ± 3.95 vs. 30.52 ± 5.46, p < 0.0025). Evidence of concentric remodeling remained in T2D remission vs. controls (left ventricular mass/volume ratio 0.88 ± 0.10 vs. 0.80 ± 0.10, p < 0.025). T2D remission is associated with an improved metabolic risk profile and ventilatory response to exercise without concomitant improvements in cardiovascular structure or function. There is a requirement for continued attention to risk factor control for this important patient population.
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影响因子：
--
作者：
Bilak, Joanna M.;Alam, Uazman;Miller, Christopher A.;McCann, Gerry P.;Arnold, Jayanth R.;Kanagala, Prathap
通讯作者：
Kanagala, Prathap
影响因子：
3.7
作者：
St Pierre TG;House MJ;Bangma SJ;Pang W;Bathgate A;Gan EK;Ayonrinde OT;Bhathal PS;Clouston A;Olynyk JK;Adams LA
通讯作者：
Adams LA
影响因子：
4
作者：
Ministrini S;Puspitasari YM;Beer G;Liberale L;Montecucco F;Camici GG
通讯作者：
Camici GG
影响因子：
3.5
作者：
Dambha-Miller, H.;Day, A. J.;Griffin, S. J.
通讯作者：
Griffin, S. J.
影响因子：
4.8
作者：
Arena, R;Myers, J;Peberdy, MA
通讯作者：
Peberdy, MA