학술논문
Galectin-3, Metabolic Risk, and Incident Heart Failure: The ARIC Study.
Document Type
Academic Journal
Author
Echouffo-Tcheugui JB; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine Johns Hopkins University Baltimore MD.; Zhang S; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health Baltimore MD United States.; Florido R; Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore MD.; Pankow JS; Department of Epidemiology at the University of Minnesota Minneapolis MN.; Michos ED; Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore MD.; Goldberg RB; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Miami Miami FL.; Nambi V; Section of Cardiovascular Research Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center Houston TX.; Gerstenblith G; Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore MD.; Post WS; Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore MD.; Blumenthal RS; Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore MD.; Ballantyne CM; Section of Cardiovascular Research Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center Houston TX.; Coresh J; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health Baltimore MD United States.; Selvin E; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health Baltimore MD United States.; Ndumele CE; Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore MD.
Source
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
Subject
Language
English
Abstract
Background: It is unclear how metabolic syndrome (MetS) and diabetes affect Gal-3 (galectin 3) levels and the resulting implications for heart failure (HF) risk. We assessed relationships of MetS and diabetes with Gal-3, and their joint associations with incident HF.
Methods and Results: We included 8445 participants without HF (mean age, 63 years; 59% men; 16% Black race) at ARIC (Atherosclerosis Risk in Communities) study visit 4 (1996-1999). We categorized participants as having MetS only, MetS with diabetes, or neither, and by quartiles of MetS severity Z score. We assessed cross-sectional associations of metabolic risk categories with high Gal-3 level (≥75th percentile) using logistic regression. We used Cox regression to evaluate combined associations of metabolic risk categories and Gal-3 quartiles with HF. In cross-sectional analyses, compared with no MetS and no diabetes, MetS only (odds ratio [OR], 1.24 [95% CI, 1.10-1.41]) and MetS with diabetes (OR, 1.59 [95% CI, 1.32-1.92]) were associated with elevated Gal-3. Over a median follow-up of 20.5 years, there were 1749 HF events. Compared with individuals with neither diabetes nor MetS and with Gal-3 in the lowest quartile, the combination of MetS with diabetes and Gal-3 ≥75th percentile was associated with a 4-fold higher HF risk (hazard ratio, 4.35 [95% CI, 3.30-5.73]). Gal-3 provided HF prognostic information above and beyond MetS, NT-proBNP (N-terminal pro-B-type natriuretic peptide), high-sensitivity cardiac troponin T, and CRP (C-reactive protein) (ΔC statistic for models with versus without Gal-3: 0.003; P =0.004).
Conclusions: MetS and diabetes are associated with elevated Gal-3. The HF risk significantly increased with the combination of greater metabolic risk and higher Gal-3.
Methods and Results: We included 8445 participants without HF (mean age, 63 years; 59% men; 16% Black race) at ARIC (Atherosclerosis Risk in Communities) study visit 4 (1996-1999). We categorized participants as having MetS only, MetS with diabetes, or neither, and by quartiles of MetS severity Z score. We assessed cross-sectional associations of metabolic risk categories with high Gal-3 level (≥75th percentile) using logistic regression. We used Cox regression to evaluate combined associations of metabolic risk categories and Gal-3 quartiles with HF. In cross-sectional analyses, compared with no MetS and no diabetes, MetS only (odds ratio [OR], 1.24 [95% CI, 1.10-1.41]) and MetS with diabetes (OR, 1.59 [95% CI, 1.32-1.92]) were associated with elevated Gal-3. Over a median follow-up of 20.5 years, there were 1749 HF events. Compared with individuals with neither diabetes nor MetS and with Gal-3 in the lowest quartile, the combination of MetS with diabetes and Gal-3 ≥75th percentile was associated with a 4-fold higher HF risk (hazard ratio, 4.35 [95% CI, 3.30-5.73]). Gal-3 provided HF prognostic information above and beyond MetS, NT-proBNP (N-terminal pro-B-type natriuretic peptide), high-sensitivity cardiac troponin T, and CRP (C-reactive protein) (ΔC statistic for models with versus without Gal-3: 0.003; P =0.004).
Conclusions: MetS and diabetes are associated with elevated Gal-3. The HF risk significantly increased with the combination of greater metabolic risk and higher Gal-3.