生长分化因子-15与左心室舒张功能及动脉僵硬度的关系

目的:在中年体检人群中,探讨血浆生长分化因子-15(GDF-15)与左心室舒张功能及动脉僵硬度的关系。方法:于我院体检中心收集178名中年人进行横断面研究,使用标准流行病学调查表进行问卷,测量血压并测定血清空腹生化指标。用酶联免疫吸附双抗夹心法测定血浆GDF-15水平,并将受试者的血浆GDF-15按三分位数分组:一分位组(<103.96 pg/ml)、二分位组(103.96 pg/ml～121.56 pg/ml)、三分位组(>121.56 pg/ml)。采用超声心动图测定左心室舒张功能、结构指标;应用VP-1000动脉硬化分析仪测定受试者臂踝脉搏波传导速度(baPWV)。结果:①随着血浆GDF-15水平的升高,舒张早期心肌血流速度峰值(E)和舒张晚期血流速度峰值(A)比值(E/A)、舒张早期心肌运动速度峰值(E’)均呈逐步下降(P<0.05),而E/E’与baPWV均呈逐步升高(P<0.05),差异均有统计学意义。②多元逐步线性回归分析:logGDF-15和年龄均是baPWV与E’、E/E’的独立影响因素(P<0.05);③偏相关分析:调整年龄、性别等后,baPWV与E’呈负相关(P<0.05),与E/E’呈正相关(P<0.01);按血浆GDF-15水平三分位数分组后,在三分位组中仍可得到相似的结果(P<0.05)。结论:在中年体检人群中,GDF-15分别是动脉僵硬度增加和左心室舒张功能减退的独立危险因素,且GDF-15水平的升高可能影响动脉弹性和左心室舒张功能的关系。

The Association of Growth Differentiation Factor-15 With Left Ventricular Diastolic Function and Arterial Stiffness in Middle-Aged Individuals

Objective:To explore the association of growth differentiation factor-15(GDF-15)with left ventricular diastolic function and arterial stiffness in middle-aged individuals. Methods:A total of 178 middle-aged(30~60 years)individuals from physical examination center in our hospital were randomly studied.The participants’ information was collected by standard questionnaire,blood pressure and fasting blood biochemical index were also measured.GDF-15 was examined with ELISA.The participants were divided into three groups as GDF-15<103.96 pg/ml,GDF-15(103.96 pg/ml～121.56)pg/ml,and GDF-15>121.56 pg/ml.Left ventricular structure and diastolic function were measured by Color Doppler ultrasound,brachial ankle pulse wave velocity(baPWV)was determined by the full-automatic arteriosclerosis diagnostic instrument. Results:①With increased levels of GDF-15,E/A and E’ decreased accordingly,E/E’ and baPWV increased accordingly,P<0.05 respectively.②Multivariate stepwise linear regression analysis presented that log GDF-15 and age were the independent influencing factors for baPWV,E’ and E/E’,P<0.05 respectively.③With adjusted age and gender,baPWV was negatively related to E’,P<0.05,and positively related to E/E’,P<0.01.The similar results could also be found in three different groups all P<0.05. Conclusion:GDF-15 was an independent risk factor for increased arterial stiffness and decreased left ventricular diastolic function,and the elevated GDF-15 may affect the relationship between arterial stiffness and left ventricular diastolic function in middle aged individuals.