中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
9期
1238-1240
,共3页
吴铿%游琼%李腾%李上海%莫海亮%叶少强%黄瑞娜
吳鏗%遊瓊%李騰%李上海%莫海亮%葉少彊%黃瑞娜
오갱%유경%리등%리상해%막해량%협소강%황서나
糖尿病心肌病%E26转录因子1%基质金属蛋白酶9
糖尿病心肌病%E26轉錄因子1%基質金屬蛋白酶9
당뇨병심기병%E26전록인자1%기질금속단백매9
Diabetic cardiomyopathy%E26 transcription factor 1%Matrix metalloproteinase 9
目的 探讨糖尿病心肌病(DCM)与外周血单个核细胞E26转录因子(Ets)1的表达相关性,初步探讨Ets-1在DCM发病机制中可能的作用,为临床诊治DCM提供新的思路.方法 选择2010年1-12月广东医学院附属医院DCM患者28例(DCM组)、单纯2型糖尿病患者30例(2型糖尿病组)和同期体检健康者30例(对照组).采用SYBR Green Ⅰ实时荧光定量逆转录聚合酶链反应检测外周血单个核细胞Ets-1 mRNA表达,记录其他临床及实验室生化指标.结果 ①DCM组LDL-C、TG高于对照组,二尖瓣舒张早期血流速度峰值/舒张晚期血流速度峰值(E/A)比值低于对照组,组间差异均有统计学意义[LDL-C:(3.3±1.2) mmol/L比(2.5±0.8) mmol/L,TG:(3.5±1.8) mmol/L比(1.8 ±0.6)mmol/L,E/A:(0.45±0.14)比(1.24 ±0.16),均P＜0.05]；DCM组和2型糖尿病组空腹血糖(FBG)、糖化血红蛋白(HbA1c)均高于对照组,组间差异均有统计学意义[DCM组分别为(8.7±3.6) mmol/L和(8.5±2.6)％,2型糖尿病组分别为(9.0±2.5) mmol/L和(9.0±1.6)％,对照组分别为(5.4±1.2) mmol/L和(5.3±1.2)％,均P＜0.05].DCM组E/A低于2型糖尿病组(0.93±0.34),组间差异有统计学意义(P＜0.05).②DCM组单个核细胞Ets-1 mRNA表达明显高于对照组,组间差异有统计学意义(0.58±0.17比0.42 ±0.15,P＜0.05)；DCM组和2型糖尿病组基质金属蛋白酶(MMP)9表达[(3.7±0.8)、(2.1±0.6)μg/L]均明显高于对照组[(1.5±0.5) μg/L],差异均有统计学意义(均P＜0.05),DCM组与2型糖尿病组间差异无统计学意义(P＞0.05).③DCM患者Ets-1 mRNA表达与MMP-9呈正相关(r=0.81,P=0.03),与E/A比值、FBG、HbA1c、LDL-C、TG无相关性(r值分别为-0.52、0.73、0.26、0.06、0.72,均P＞0.05).④DCM危险因素分析结果显示Ets-1 mRNA高表达为危险因素[比值比=3.12,95％置信区间:2.14 ～4.48,P＜0.05].结论 Ets-1可上调MMP-9表达,参与2型糖尿病的发生发展,Ets-1可作为DCM的早期预测因子.
目的 探討糖尿病心肌病(DCM)與外週血單箇覈細胞E26轉錄因子(Ets)1的錶達相關性,初步探討Ets-1在DCM髮病機製中可能的作用,為臨床診治DCM提供新的思路.方法 選擇2010年1-12月廣東醫學院附屬醫院DCM患者28例(DCM組)、單純2型糖尿病患者30例(2型糖尿病組)和同期體檢健康者30例(對照組).採用SYBR Green Ⅰ實時熒光定量逆轉錄聚閤酶鏈反應檢測外週血單箇覈細胞Ets-1 mRNA錶達,記錄其他臨床及實驗室生化指標.結果 ①DCM組LDL-C、TG高于對照組,二尖瓣舒張早期血流速度峰值/舒張晚期血流速度峰值(E/A)比值低于對照組,組間差異均有統計學意義[LDL-C:(3.3±1.2) mmol/L比(2.5±0.8) mmol/L,TG:(3.5±1.8) mmol/L比(1.8 ±0.6)mmol/L,E/A:(0.45±0.14)比(1.24 ±0.16),均P＜0.05]；DCM組和2型糖尿病組空腹血糖(FBG)、糖化血紅蛋白(HbA1c)均高于對照組,組間差異均有統計學意義[DCM組分彆為(8.7±3.6) mmol/L和(8.5±2.6)％,2型糖尿病組分彆為(9.0±2.5) mmol/L和(9.0±1.6)％,對照組分彆為(5.4±1.2) mmol/L和(5.3±1.2)％,均P＜0.05].DCM組E/A低于2型糖尿病組(0.93±0.34),組間差異有統計學意義(P＜0.05).②DCM組單箇覈細胞Ets-1 mRNA錶達明顯高于對照組,組間差異有統計學意義(0.58±0.17比0.42 ±0.15,P＜0.05)；DCM組和2型糖尿病組基質金屬蛋白酶(MMP)9錶達[(3.7±0.8)、(2.1±0.6)μg/L]均明顯高于對照組[(1.5±0.5) μg/L],差異均有統計學意義(均P＜0.05),DCM組與2型糖尿病組間差異無統計學意義(P＞0.05).③DCM患者Ets-1 mRNA錶達與MMP-9呈正相關(r=0.81,P=0.03),與E/A比值、FBG、HbA1c、LDL-C、TG無相關性(r值分彆為-0.52、0.73、0.26、0.06、0.72,均P＞0.05).④DCM危險因素分析結果顯示Ets-1 mRNA高錶達為危險因素[比值比=3.12,95％置信區間:2.14 ～4.48,P＜0.05].結論 Ets-1可上調MMP-9錶達,參與2型糖尿病的髮生髮展,Ets-1可作為DCM的早期預測因子.
목적 탐토당뇨병심기병(DCM)여외주혈단개핵세포E26전록인자(Ets)1적표체상관성,초보탐토Ets-1재DCM발병궤제중가능적작용,위림상진치DCM제공신적사로.방법 선택2010년1-12월엄동의학원부속의원DCM환자28례(DCM조)、단순2형당뇨병환자30례(2형당뇨병조)화동기체검건강자30례(대조조).채용SYBR Green Ⅰ실시형광정량역전록취합매련반응검측외주혈단개핵세포Ets-1 mRNA표체,기록기타림상급실험실생화지표.결과 ①DCM조LDL-C、TG고우대조조,이첨판서장조기혈류속도봉치/서장만기혈류속도봉치(E/A)비치저우대조조,조간차이균유통계학의의[LDL-C:(3.3±1.2) mmol/L비(2.5±0.8) mmol/L,TG:(3.5±1.8) mmol/L비(1.8 ±0.6)mmol/L,E/A:(0.45±0.14)비(1.24 ±0.16),균P＜0.05]；DCM조화2형당뇨병조공복혈당(FBG)、당화혈홍단백(HbA1c)균고우대조조,조간차이균유통계학의의[DCM조분별위(8.7±3.6) mmol/L화(8.5±2.6)％,2형당뇨병조분별위(9.0±2.5) mmol/L화(9.0±1.6)％,대조조분별위(5.4±1.2) mmol/L화(5.3±1.2)％,균P＜0.05].DCM조E/A저우2형당뇨병조(0.93±0.34),조간차이유통계학의의(P＜0.05).②DCM조단개핵세포Ets-1 mRNA표체명현고우대조조,조간차이유통계학의의(0.58±0.17비0.42 ±0.15,P＜0.05)；DCM조화2형당뇨병조기질금속단백매(MMP)9표체[(3.7±0.8)、(2.1±0.6)μg/L]균명현고우대조조[(1.5±0.5) μg/L],차이균유통계학의의(균P＜0.05),DCM조여2형당뇨병조간차이무통계학의의(P＞0.05).③DCM환자Ets-1 mRNA표체여MMP-9정정상관(r=0.81,P=0.03),여E/A비치、FBG、HbA1c、LDL-C、TG무상관성(r치분별위-0.52、0.73、0.26、0.06、0.72,균P＞0.05).④DCM위험인소분석결과현시Ets-1 mRNA고표체위위험인소[비치비=3.12,95％치신구간:2.14 ～4.48,P＜0.05].결론 Ets-1가상조MMP-9표체,삼여2형당뇨병적발생발전,Ets-1가작위DCM적조기예측인자.
Objective To primarily discuss the role of E26 transcription factor (Ets) 1 in peripheral blood mononuclear cell of the patients with diabetic cardiomyopathy(DCM) and to provide the new measure to cure DCM.Methods DCM group (n =28) and type 2diabetic mellitus(T2DM) group (n =30),control group (n =30).The expression of Ets-1 mRNA on peripheral-blood mononuclear cells was examined by SYBR Green Ⅰ real-time quantitative reverse transcription ploymerse chain reaction.Results The levels of low density lipoprotein cholesterol (LDL-C) and triglyceride(TG) in DCM group were significantly higher than those in control group,the E/A in DCM group was significantly lower than that in control group [LDL-C:(3.3 ± 1.2) mmol/L vs (2.5 ± 0.8) mtol/L,TG:(3.5 ± 1.8) mmol/L vs (1.8 ± 0.6) mmol/L,E/A:(0.45 ± 0.14) vs (1.24 ± 0.16),P ＜ 0.05].The levels of fasting blood glucose(FBG) and glycosylated hemoglobin(Hb) A1c in DCM and T2DM groups were significantly higher than those in control group [DCM group (8.7 ± 3.6) mmol/L and (8.5 ± 2.6) ％,T2DM (9.0 ± 2.5) mmol/L and (9.0 ± 1.6) ％,control group (5.4 ± 1.2) mmol/L and (5.3 ± 1.2) ％,P ＜ 0.05].The E/A in DCM group was significantly lower than that in T2DM group(0.93 ±0.34) (P ＜0.05).The expression of Ets-1 mRNA on peripheral-blood mononuclear cells in DCM group were significantly higher than that in control group (0.58 ±0.17 vs 0.42 ± 0.15,P ＜ 0.05).The expression of matrix metalloproteinase(MMP) 9 in DCM group and T2DM group were significantly higher than those in control group [(3.7 ± 0.8) μg/L and (2.1 ± 0.6) μg/L vs (1.5 ± 0.5) μg/L,P ＜ 0.05],there were not statistically significant between DCM group and T2DM group (P ＜ 0.05).The expression of Ets-1 were correlated positively with MMP-9 in DCM (r =0.81,P =0.03),and there were not correlated positively with E/A,FBG,HbA1c,LDL-C and TG (r =-0.52,0.73,0.26,0.06,0.72,all P ＞ 0.05).Logistic regression analysis showed that Ets-1 was high risk factors of DCM [odd ratio (OR) =1.31,95％ confidonce interval (CI):2.14-4.48,P ＜ 0.05].Conclusion Ets-1 can up-regulate the expression of MMP-9 in the progress of DM,but only Ets-1 can be a predictor of DCM.
