Evaluation value of serum adiponectin and pancreatic β-cell function index for diabetic cardiomyopathy and cardiac dysfunction

doi:10.11958/20260146

Abstract

Abstract:

Objective To investigate the levels of serum adiponectin (APN) and homeostasis model assessment of β-cell function (HOMA-β) in patients with diabetic cardiomyopathy (DCM), and to analyze their relationship with the occurrence of DCM and cardiac function impairment. Methods A retrospective case-control study was conducted. A total of 106 DCM patients admitted to the hospital from March 2021 to March 2023 were enrolled as the observation group. Another 106 patients with type 2 diabetes mellitus (T2DM) without cardiomyopathy, coronary heart disease, or cardiac insufficiency during the same period were selected as the control group. The general data, serum APN, HOMA-β and cardiac function indicators were compared between the two groups. Pearson correlation analysis was used to evaluate the correlation between APN, HOMA-β and cardiac function indicators. Multivariate Logistic regression analysis was used to analyze the influencing factors of DCM. Receiver operating characteristic (ROC) curve analysis was used to assess the evaluation value of APN and HOMA-β for DCM. Results There were no statistically significant differences in baseline data such as age, gender, BMI, smoking history, drinking history, comorbidities, use of hypoglycemic drugs, HDL-C, LDL-C, TC, TG, HbA1c, Scr and UA between the two groups (P>0.05). However, the duration of diabetes was longer in the observation group than that in the control group (P<0.05). Compared with the control group, levels of serum APN, HOMA-β, the ratio of early to late diastolic mitral inflow velocities (E/A) and left ventricular ejection fraction (LVEF) were decreased, while left ventricular end-diastolic volume (LVEDV) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were increased in the observation group (P<0.05). Pearson correlation analysis showed that both APN and HOMA-β were positively correlated with E/A and LVEF, and negatively correlated with LVEDV and NT-proBNP (P<0.05). Multivariate Logistic regression analysis showed that a long duration of diabetes was a risk factor for developing DCM, while high levels of serum APN and HOMA-β were protective factors for DCM (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for APN and HOMA-β alone in evaluating DCM were 0.790 (95%CI: 0.729-0.843) and 0.761 (95%CI: 0.697-0.816), respectively. The AUC for their combined evaluation increased to 0.903 (95%CI: 0.855-0.940). DeLong's test indicated that the diagnostic efficacy of the combined evaluation model was significantly superior to that of APN alone (Z = 2.974,P<0.01) and HOMA-β alone (Z = 5.237, P<0.01). Conclusion Serum levels of APN and HOMA-β in DCM patients are correlated with cardiac function impairment indicators. Both may be potential biomarkers for evaluating DCM and cardiac function impairment, and the combined detection has a higher value.

Key words: diabetic cardiomyopathies, adiponectin, heart function tests, echocardiography, HOMA-β

CLC Number:

R587

Figures/Tables 6

References 22

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组别		年龄/岁		性别（男/女）		BMI/（kg/m²）			吸烟史	饮酒史		糖尿病病程/年		合并症				HDL-C/（mmol/L）
组别		年龄/岁		性别（男/女）		BMI/（kg/m²）			吸烟史	饮酒史		糖尿病病程/年		高血压		高血脂		HDL-C/（mmol/L）
对照组		66.15±4.54		63（59.43）/43（40.57）		25.11±1.97			38（35.85）	40（37.74）		9.40±3.86		47（44.34）		22（20.75）		1.38±0.30
观察组		64.85±5.27		62（58.49）/44（41.51）		24.68±2.11			34（32.08）	38（35.85）		15.32±5.11		46（43.40）		21（19.81）		1.37±0.29
t或χ²		1.928		0.019		1.502			0.337	0.081		9.491^＊＊		0.006		0.029		0.247
组别	降糖药物使用情况							LDL-C/ （mmol/L）			TC/ （mmol/L）		TG/ （mmol/L）		HbA1c/ %		Scr/ （μmol/L）		UA/ （μmol/L）
组别	二甲双胍		SGLT2i		GLP-1RA		胰岛素	LDL-C/ （mmol/L）			TC/ （mmol/L）		TG/ （mmol/L）		HbA1c/ %		Scr/ （μmol/L）		UA/ （μmol/L）
对照组	85（80.19）		30（28.30）		22（20.75）		25（23.58）	2.95±0.70			3.84±0.49		1.72±0.38		8.60±2.21		82.15±16.89		352.12±64.11
观察组	88（83.02）		32（30.19）		25（23.58）		28（26.42）	2.93±0.61			3.70±0.55		1.66±0.40		8.68±2.15		80.25±11.20		350.21±65.12
t或χ²	0.283		0.091		0.246		0.226	0.223			1.959		1.119		0.267		0.960		0.215

组别		年龄/岁		性别（男/女）		BMI/（kg/m²）			吸烟史	饮酒史		糖尿病病程/年		合并症				HDL-C/（mmol/L）
组别		年龄/岁		性别（男/女）		BMI/（kg/m²）			吸烟史	饮酒史		糖尿病病程/年		高血压		高血脂		HDL-C/（mmol/L）
对照组		66.15±4.54		63（59.43）/43（40.57）		25.11±1.97			38（35.85）	40（37.74）		9.40±3.86		47（44.34）		22（20.75）		1.38±0.30
观察组		64.85±5.27		62（58.49）/44（41.51）		24.68±2.11			34（32.08）	38（35.85）		15.32±5.11		46（43.40）		21（19.81）		1.37±0.29
t或χ²		1.928		0.019		1.502			0.337	0.081		9.491^＊＊		0.006		0.029		0.247
组别	降糖药物使用情况							LDL-C/ （mmol/L）			TC/ （mmol/L）		TG/ （mmol/L）		HbA1c/ %		Scr/ （μmol/L）		UA/ （μmol/L）
组别	二甲双胍		SGLT2i		GLP-1RA		胰岛素	LDL-C/ （mmol/L）			TC/ （mmol/L）		TG/ （mmol/L）		HbA1c/ %		Scr/ （μmol/L）		UA/ （μmol/L）
对照组	85（80.19）		30（28.30）		22（20.75）		25（23.58）	2.95±0.70			3.84±0.49		1.72±0.38		8.60±2.21		82.15±16.89		352.12±64.11
观察组	88（83.02）		32（30.19）		25（23.58）		28（26.42）	2.93±0.61			3.70±0.55		1.66±0.40		8.68±2.15		80.25±11.20		350.21±65.12
t或χ²	0.283		0.091		0.246		0.226	0.223			1.959		1.119		0.267		0.960		0.215

组别	APN/（mg/L）	HOMA-β/%	E/A	LVEF/%	LVEDV/mL	NT-proBNP/（ng/L）
对照组	4.38±0.51	70.87±9.57	1.13±0.21	54.75±2.94	53.12±2.57	885.29±141.12
观察组	3.86±0.42	64.12±9.15	0.84±0.18	52.86±2.41	62.45±4.85	1 782.14±352.12
t	8.317^＊＊	5.246^＊＊	10.764^＊＊	5.120^＊＊	17.480^＊＊	24.341^＊＊

组别	APN/（mg/L）	HOMA-β/%	E/A	LVEF/%	LVEDV/mL	NT-proBNP/（ng/L）
对照组	4.38±0.51	70.87±9.57	1.13±0.21	54.75±2.94	53.12±2.57	885.29±141.12
观察组	3.86±0.42	64.12±9.15	0.84±0.18	52.86±2.41	62.45±4.85	1 782.14±352.12
t	8.317^＊＊	5.246^＊＊	10.764^＊＊	5.120^＊＊	17.480^＊＊	24.341^＊＊

指标	E/A	LVEF	LVEDV	NT-proBNP
APN	0.667^＊＊	0.662^＊＊	-0.313^＊＊	-0.352^＊＊
HOMA-β	0.420^＊＊	0.367^＊＊	-0.395^＊＊	-0.418^＊＊