在有妊娠糖尿病病史的患者中,球过和冠状动脉流速储备之间是否存在关联?
Mumtaz Takir1, Ozge Telci Caklili2, Fatma Betul Ozcan3
1Department of Endocrinology and Metabolism, Suleyman Yalcin City Hospital, Istanbul, Türkiye.
Biomolecules & biomedicine
|September 5, 2024
概括
在有妊娠糖尿病史的女性中,淋巴细胞过 (GHF) 与降低冠状动脉流速储量 (CFVR) 有关,这表明微血管功能障碍. 像HbA1c和HOMA-IR这样的代谢因素与这种降低的CFVR有关.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
背景情况:
- 淋巴细胞过 (GHF) 是慢性病 (CKD) 的早期指标.
- GHF可能预测冠状动脉微血管功能障碍 (CMD),其特点是冠状动脉流速储备 (CFVR) 减少.
- 孕期糖尿病 (GDM) 病史的女性患CKD和心血管疾病的风险增加.
研究的目的:
- 为了评估膜过率 (GFR),并比较CFVR在患者有史以来的GDM.
- 在这个人群中调查GFR水平,代谢参数和CFVR之间的关系.
主要方法:
- 曾经患有GDM的患者因胸痛而转诊 (不包括积极的跑步机测试) 被按GFR分类:第一组 (60-89毫升/分钟),第二组 (90-119毫升/分钟) 和第三组 (≥120毫升/分钟).
- 冠状动脉扩张性峰值速度在基线和二皮里达摩尔 (dipyridamole) 后被测量,以计算CFVR.
- 分析了胰岛素耐药性 (HOMA-IR) 和HbA1c的恒温模式评估.
主要成果:
- 总共有166名患者被纳入. 与2组相比,3组 (GHF) 的HOMA-IR显著更高.
- 在第一组 (CKD范围) 中,CFVR最低,在第二组 (正常GFR) 中最高,在第三组 (GHF) 中适度降低.
- 多变量分析确定HbA1c是减少CFVR的独立预测因素.
结论:
- 在有GDM病史的女性中,球过与冠状动脉流速储备的减少有关.
- 代谢参数,包括HbA1c和HOMA-IR,与这种冠状动脉微血管功能受损有关.
- 针对代谢健康的干预措施可能对预防GDM患者心血管疾病至关重要.
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