Could Ghrelin Expression Regulate Diastolic Cardiac Function in Type 2 Diabetic Obese Patients?

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2025-05-05 DOI:10.1002/dmrr.70049

Celestino Sardu, Nunzia D'Onofrio, Maria Consiglia Trotta, Maria Luisa Balestrieri, Giovanni Francesco Nicoletti, Giovanbattista D'Amico, Carlo Fumagalli, Carla Contaldi, Giuseppe Pacileo, Lucia Scisciola, Maddalena Nicoletti, Ludovica Vittoria Marfella, Matilde Sbriscia, Ferdinando Carlo Sasso, Giuseppe Signoriello, Giuseppe Paolisso, Raffaele Marfella

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引用次数: 0

Abstract

Aims

Adipose tissue expresses cytokines, sirtuin-1 (SIRT1), and microRNAs (miRs), regulating left ventricle (LV)-diastolic function (LV-DF). Ghrelin could modulate these pathways in patients with type 2 diabetes mellitus (T2DM) and obesity. We investigated ghrelin expression in T2DM obese patients after abdominal fat excision, and in those with LV-DF normalisation at 1 year of follow-up.

Materials and methods

Two-hundred and two T2DM obese patients enroled for abdominoplastic surgery were divided into those with normal LV-DF (group 1: E/E′ < 9, n 76) and those with altered LV-DF: group 2 (9 < E/E′ < 14; n 96) and group 3 (E/E′ > 14, n 28).

Results

Patients with LV-diastolic dysfunction had over-inflammation, lower SIRT1 and higher abdominal fat sodium-glucose-transporter-two (SGLT2) expression (p < 0.05). They did not differ for ghrelin expression (p > 0.05). They evidenced different tissue/serum expression of miR-21, miR-92 and miR-126 (p < 0.05). Group 2 versus group 1 over-expressed tissue inflammatory markers and SGLT2 (p < 0.05), with higher extent in group 3 versus group 1 (p < 0.01) and versus group 2 (p < 0.025). SIRT1 was downregulated in group 2 versus group 1 (p < 0.05), and versus group 3 (p < 0.01). At the follow-up end, patients with lower LV-diastolic dysfunction had lower inflammation and SGLT2, and higher serum ghrelin (p < 0.05). They increased miR-126, and reduced serum miR-21 and miR-92 expression. At the follow-up end, 50 patients experienced LV-DF normalisation, which was predicted by tissue miR-126 (HR 1.344, CI 95% 1.126–1.937), and ghrelin (HR 1.123, CI 95% 1.016–1.310).

Conclusions

In T2DM obese patients, abdominal fat excision could reduce inflammation, up-regulating serum ghrelin and inducing miRs implied in LV-DF normalisation at 1 year of follow-up.

Clinical research trial number

NCT05988346.

Abstract Image

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Ghrelin的表达是否能调节2型糖尿病肥胖患者的舒张心功能？

目的脂肪组织表达细胞因子、sirtuin-1 （SIRT1）和microrna (miRs)，调节左心室（LV）舒张功能（LV- df）。Ghrelin可以调节2型糖尿病（T2DM）和肥胖患者的这些途径。我们研究了腹部脂肪切除术后的T2DM肥胖患者以及随访1年的LV-DF正常化患者的胃饥饿素表达情况。材料与方法入选腹部整形手术的222例T2DM肥胖患者分为LV-DF正常组(1组：E/E ' <；9, n 76)和LV-DF改变组：2组(9 <；E / E”& lt;14;n 96)和第3组(E/E ' >；14, n 28)。结果左室舒张功能障碍患者存在过度炎症，SIRT1降低，腹部脂肪钠-葡萄糖转运体- 2 （SGLT2）表达升高(p <；0.05)。他们在胃饥饿素表达上没有差异(p >；0.05)。他们证实了miR-21、miR-92和miR-126在组织/血清中的不同表达(p <；0.05)。组2与组1过表达组织炎症标志物和SGLT2 (p <；0.05)，且3组高于1组(p <；0.01)与第二组比较(p <；0.025)。与1组相比，2组SIRT1下调(p <；0.05)，与第3组比较(p <；0.01)。随访结束时，低左室舒张功能障碍患者的炎症和SGLT2较低，血清ghrelin较高(p <；0.05)。他们增加miR-126，降低血清miR-21和miR-92的表达。在随访结束时，50例患者经历了LV-DF正常化，这是由组织miR-126 （HR 1.344, CI 95% 1.126-1.937）和ghrelin （HR 1.123, CI 95% 1.016-1.310）预测的。结论在T2DM肥胖患者中，腹部脂肪切除可减少炎症，上调血清ghrelin，并诱导mir，这与随访1年的LV-DF正常化有关。临床研究试验编号NCT05988346。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.