高灵敏性心脏热素T和I在血糖状况上的分布和预后值:基于人口的研究
Jiajun Zhang1,2,3,4,5, Xiaoxing Li6, Shenglin Zhang1,2,3,4,5
1Department of Emergency Medicine, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
Cardiovascular diabetology
|February 24, 2024
概括
高灵敏性心脏热素 (hs-cTn) T和I水平与所有血糖状况的死亡率有关. 然而,hs-cTn试验提供了增量预后价值,特别是在糖尿病人群中,用于预测心脏事件.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 生物标志物研究 生物标志物研究
背景情况:
- 在不同血糖状态 (常态血糖,糖尿病前期,糖尿病) 中,高灵敏性心脏热素 (hs-cTn) T和I的差异分布和预后意义尚不清楚.
- 了解这些差异对于在不同人群中准确评估心血管风险至关重要.
研究的目的:
- 研究hs-cTn T和I在正常血糖,糖尿病前期和糖尿病患者中的分布和预后值.
- 为了确定hs-cTn测定是否在不同的血糖组中为心脏死亡率提供增量预测价值.
主要方法:
- 从国家健康和营养检查调查 (1999-2004) 中对成年参与者的分析,具有可用的血糖状况和hs-cTn测量.
- 采用非参数方法和引导方法来确定hs-cTn试验的第99个上限.
- 采用Cox比例危险回归和竞争风险模型来评估hs-cTn与所有原因和心脏特异性死亡率的关联,以及hs-cTn对现有风险评分的增量预测值.
主要成果:
- 在所有血糖组中,hs-cTnT和hs-cTnI独立地与全因和心脏特异性死亡率相关.
- 在糖尿病患者中,hs-cTnT和hs-cTnI度与心脏特异性死亡率有显著的相关性 (aHRs~1.77-1.83每SD增加).
- 将hs-cTnT或hs-cTnI添加到风险得分中,显著改善了糖尿病人群中心脏病死亡率的预测,hs-cTnT和hs-cTnI组合显示出进一步的改善.
结论:
- Hs-cTnT和hs-cTnI在整个血糖状况中显示出一致的预后关联.
- 这些生物标志物为心血管事件提供增量预测价值,主要在高血糖人口中.
- 糖尿病中hs-cTnT百分位的独特行为表明高血糖和热素测定之间的潜在相互作用,需要进一步调查.
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