부산대학교 도서관

Objective: to find alternative biomarkers for the development of chronic heart failure (CHF) in patients with diabetes mellitus (DM). Methods: A total of 155 patients (14 men and 61 women) with type 1 and type 2 diabetes, aged 34 to 84 years, were examined. All patients underwent standard clinical and laboratory examination, with an assessment of the levels of pro-inflammatory cytokines (IL-6, TNF-alpha), chemokines (MIG, RANTES), growth factors (FGF-23, VEGF-A). A renal function was assessed based on the serum creatinine, GFR was calculated according to the CKD-EPI formula, albuminuria was assessed as albumin/creatinine ratio (A/K). An echocardiographic examination was conducted according to the standard protocol with the calculation of dimensional, volume and speed characteristics. Statistical analysis was performed using smSTATA 14.2 for Mac (2018). Results: The levels of BNP and proBNP were identified as CHF in 57% DM patients. The levels of BNP and proBNP positively correlated with the levels of homocysteine, uric acid, IL-6, CRP, hsCRP, A/K, creatinine, cystatin C, TNF-alpha, chemokines (MIG, RANTES), growth factors (FGF-23, VEGF-A) (p <0.05). According to multiple regression analysis, predictors for increasing proBNP were IL-6, A/K, creatinine (ß=0.70, p<0.001, ß=3.51, p=0.01, ß=0.97, p=0,01, respectively). ROC analysis determined the highest diagnostic significance of creatinine for predicting heart failure. The significance of IL-6 was higher than A/K (AUC-0.777). So, when the level of IL-6 (AUC- 0.789) was 3.1 mg/ml, the sensitivity and specificity for increasing proBNP concentration were 71.9% and 71.2%, respectively. Conclusion: IL-6 might be an independent predictor of the development of heart failure in patients with diabetes.