ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2021-3-72-78ssmu-4482Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSМаркеры фиброза и эхокардиографические параметры у пациентов с сахарным диабетом 2-го типа в зависимости от уровня альбуминурииFibrosis biomarkers and echocardiographic parameters in patients with type 2 diabetes depending on the degree of albuminuriahttps://orcid.org/0000-0003-1808-1331ЛебедевД. А.LebedevD. A.

 врач-эндокринолог, мл. науч. сотрудник, лаборатория диабетологии, Институт эндокринологии

 Россия, 194156, г. Санкт-Петербург, пр. Пархоменко, 15 

15, Parkhomenko Str., 194156, Saint Petersburg, Russian Federation

doctorlebedev@yandex.ruhttps://orcid.org/0000-0003-0837-8385ЛаевскаяМ. Ю.LaevskayaM. Yu.

 канд. мед. наук, ст. науч. сотрудник, лаборатория диабетологии, Институт эндокринологии

 Россия, 194156, г. Санкт-Петербург, пр. Пархоменко, 15 

15, Parkhomenko Str., 194156, Saint Petersburg, Russian Federation

https://orcid.org/0000-0002-0559-697XБабенкоА. Ю.BabenkoA. Yu.

 д-р мед. наук, зав. лабораторией диабетологии, Институт эндокринологии

 Россия, 194156, г. Санкт-Петербург, пр. Пархоменко, 15 

15, Parkhomenko Str., 194156, Saint Petersburg, Russian Federation

Национальный медицинский исследовательский центр им. В.А. АлмазоваРоссияAlmazov National Medical Research CenterRussian Federation2021201020212037278Copyright © Лебедев Д.А., Лаевская М.Ю., Бабенко А.Ю., 20212021Лебедев Д.А., Лаевская М.Ю., Бабенко А.Ю.Lebedev D.A., Laevskaya M.Y., Babenko A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/4482

Введение. Наличие диабетической нефропатии (ДН) у пациентов с сахарным диабетом 2-го типа (СД2) ассоциировано с риском развития хронической сердечной недостаточности (ХСН). Степень альбуминурии является маркером прогрессирования ДН и связана с повышенным риском ХСН.Цель. Оценка биомаркеров фиброза и эхокардиографических параметров у пациентов с СД2 без ХСН в зависимости от экскреции альбумина с мочой.Материалы и методы. В исследование были включены 42 пациентов с СД2 без установленного диагноза ХСН. Пациенты были разделены на группы: с нормальной альбуминурией и с умеренным повышением альбуминурии (альбумин/креатининовое соотношение 30–300 мг/г). Пациентам была выполнена эхокардиография, определялась концентрация галектина-3, ST-2, PIСP, ММР-9 и TIMP-1.Результаты. Группы не различались между собой по возрасту, полу, индексу массы тела (ИМТ), значениям гликированного гемоглобина (HbA1c), cкорости клубочковой фильтрации (СКФ). Концентрации галектина-3 были значимо выше в группе с умеренным повышением альбуминурии – 13,6 (11,2; 15,1) нг/мл и 7,4 (6,7; 7,9) нг/мл соответственно, р = 0,002. Группы также не различались между собой по значениям таких биомаркеров, как P1CP, TIMP-1 и MMP-9. Кроме того, группа с нормоальбуминурией имела меньшие значения E/e’, чем группа с умеренным повышением альбуминурии – 8 (7; 9) и 10 (9; 12,5), р = 0,02.Заключение. Пациенты с СД2 и умеренным повышением альбуминурии имеют большие значения галектина-3 и более выраженное нарушение диастолической функции сердца, чем пациенты с нормоальбумин урией. Выявленные изменения могут отражать более высокий риск развития хронической сердечной недостаточности в данной группе пациентов.

Background. Diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM) is associated with a risk of developing chronic heart failure (CHF). The degree of albuminuria is a marker of DN and is associated with an increased risk of chronic heart failure (CHF).Aim. To evaluate fibrosis biomarkers and echocardiographic parameters in patients with T2DM without CHF, depending on urinary albumin excretion.Materials and methods. The study included 42 patients with T2DM without verified CHF. The patients were divided into two groups: 1) a group with normoalbuminuria and 2) a group with a moderate increase in albuminuria (albumin / creatinine ratio of 30–300 mg / g). Echocardiography was performed and galectin-3, ST-2, PIСP, MMP-9, and TIMP-1 concentrations were measured.Results. The groups did not differ by age, sex, body mass index (BMI), glycated hemoglobin (HbA1c), and glomerular filtration rate (GFR). Galectin-3 concentrations were significantly higher in the group with a moderate increase in albuminuria than in the group of patients without albuminuria – 13.6 (11.2; 15.1) ng / ml and 7.4 (6.7; 7.9) ng / ml, respectively, p = 0.002. The groups also did not differ in the values of biomarkers, such as P1CP, TIMP-1, and MMP-9. Besides, the group with normoalbuminuria had lower E/e’ values than the group with a moderate increase in albuminuria – 8 (7; 9) and 10 (9; 12.5), p = 0.02.Conclusion. The patients with type 2 diabetes and a moderate increase in albuminuria have higher values of galectin-3 and a more pronounced diastolic dysfunction. The identified changes may reflect a higher risk of chronic heart failure in this group of patients.

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The authors declare that there are no conflicts of interest present.