diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/2072-0351-3752diaendo-3752Research ArticleСтатьиArticlesЦиркулирующий фактор роста гепатоцитов (HGF) у больных с хронической сердечной недостаточностью, сочетающейся с сахарным диабетом 2 типа и нарушением жирового обменаCirculating hepatocyte growth factor (HGF) in patients with comorbidity of chronic heart failure, type 2 diabetes mellitus and impaired lipid metabolismКочегураТатьяна НиколаевнаKocheguraTatiana Nikolaevna

к.м.н.

k.m.n.

t_kochegur@mail.ruМакаревичПавел ИгоревичMakarevichP I

ординатор

ordinator

dia@endojournals.ruОвчинниковАртем ГермановичOvchinnikovA G

к.м.н., с.н.с. НДО НИИ кардиологии имени А.Л. Мясникова

k.m.n., s.n.s. NDO NII kardiologii imeni A.L. Myasnikova

dia@endojournals.ruЖигуноваЛюдмила ВитальевнаZhigunovaL V

врач-кардиолог Научно-консультативного отделения НИИ кардиологии им. А.Л. Мясникова

vrach-kardiolog Nauchno-konsul'tativnogo otdeleniya NII kardiologii im. A.L. Myasnikova

dia@endojournals.ruЛаховаЕлена ЛеонидовнаLahovaElena Leonidovna

врач-кардиолог Научно-консультативного отделения НИИ кардиологии им. А.Л. Мясникова

vrach-kardiolog Nauchno-konsul'tativnogo otdeleniya NII kardiologii im. A.L. Myasnikova

dia@endojournals.ruШестаковаМарина ВладимировнаShestakovaMarina Vladimirovna

член-корр. РАМН, директор института Диабета

chlen-korr. RAMN, direktor instituta Diabeta

nephro@endocrincentr.ruАгеевФаиль ТаиповичAgeevF T

д.м.н., профессор, руководитель НДО НИИ кардиологии имени А.Л. Мясникова

d.m.n., professor, rukovoditel' NDO NII kardiologii imeni A.L. Myasnikova

dia@endojournals.ruПарфёноваЕлена ВикторовнаParfenovaElena Viktorovna

д.м.н., профессор

d.m.n., professor

dia@endojournals.ru1 ГУНУ Факультет Фундаментальной медицины МГУ имени М.В. Ломоносова, МоскваLomonosov Moscow State University, Faculty of Fundamental Medicine, MoscowФГБУ Российский кардиологический научно-производственный комплекс, МоскваRussian Cardiology Research and Production Complex, MoscowФГБУ Эндокринологический научный центр, МоскваEndocrinology Research Centre, Moscow201315062013162№2 (2013)1725Copyright © Кочегура Т.Н., Макаревич П.И., Овчинников А.Г., Жигунова Л.В., Лахова Е.Л., Шестакова М.В., Агеев Ф.Т., Парфёнова Е.В., 20132013Кочегура Т.Н., Макаревич П.И., Овчинников А.Г., Жигунова Л.В., Лахова Е.Л., Шестакова М.В., Агеев Ф.Т., Парфёнова Е.В.Kochegura T.N., Makarevich P.I., Ovchinnikov A.G., Zhigunova L.V., Lahova E.L., Shestakova M.V., Ageev F.T., Parfenova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/3752Цель

Цель. Оценка уровня циркулирующего фактора роста гепатоцитов (HGF) в плазме крови больных с постинфарктной хро- нической сердечной недостаточностью (ХСН), сочетающейся с сахарным диабетом 2 типа (СД2) и ожирением. Изучение связи уровня HGF с показателями углеводного и жирового обмена, классическими биохимическими маркерами тяжести ХСН, параметрами функции сердца.

Материалы и методы

Материалы и методы. В исследовании принимали участие 100 пациентов, среди которых 20 человек составили группу контроля, 30 больных с ХСН, 25 больных с ХСН, сочетающейся с СД2, и 25 больных с СД2 без ХСН. Количественное определение циркулирующего HGF плазмы крови проводилось методом твердофазного иммуноферментного анализа (ELISA).

Результаты

Результаты. Уровень HGF повышен в плазме крови больных с ХСН и больных с СД2 типа в сравнении с группой контроля. Наиболее значительное повышение HGF наблюдается у больных с ХСН, сочетающейся с СД2, и коррелирует с уровнем гликированного гемоглобина (r=0,52, p=0,03). В объединенной группе пациентов уровень HGF коррелирует с величиной индекса массы тела (ИМТ) (r=0,42, p=0007). В контрольной группе у лиц с ИМТ больше 30 кг/м2 уровень HGF был достоверно выше, чем у пациентов с ИМТ менее 30 кг/м2 (324,1?107,7 пг/мл vs 436,9?112,3 пг/мл, p=0,03). В группах больных достоверных различий в зависимости от величины ИМТ обнаружено не было, хотя тенденция к более высокому уровню HGF у больных с ожирением наблюдалась в группе больных с ХСН, сочетающейся с СД2 (626,1?254,1 пг/мл vs 742,0?210,7 пг/мл соответственно, p >0,05).Циркулирующий уровень HGF коррелирует с концентрацией натрийуретического пептида NT-proBNP в сыворотке и структурно-функциональными параметрами сердца, такими как размер и максимальный объем левого предсердия, фрак- ция выброса левого желудочка, конечно-систолический размер и конечно-систолический объем, конечно-диастолический размер и конечно-диастолический объем, что позволяет рассматривать HGF в качестве кандидатного маркера неблагоприятного ремоделирования миокарда при постинфарктной ХСН.

Заключение

Заключение. Уровень HGF в плазме крови может явиться маркером неблагоприятного прогноза при ХСН, сочетающейся с метаболическими расстройствами (СД2 и ожирением), что должно быть проверено в проспективных исследованиях.

AIM

AIM: To evaluate the plasma level of circulating heptocyte growth factor (HGF) in patients with comorbidity of post-infarction chronic heart failure (CHF), type 2 diabetes mellitus (T2DM) and obesity. We also aimed to assess possible correlations between HGF levels and parameters of carbohydrate and lipid metabolism, as well as myocardial functional characteristics and classic biochemical severity markers for CHF.17Сахар ный диабет КардиологияСахарный диабет. 2013;(2):17-25

MATERIALS AND METHODS

MATERIALS AND METHODS: We enrolled 100 patients for participation in this study, including the following subgroups: 20 individuals with- out cardiovascular and glycemic disorders, 30 patients with CHF, 25 patients with CHF/T2DM comorbidity and 25 diabetic patients with no signs of heart failure. Quantitative plasma HGF analysis was performed with enzyme-linked immunosorbent assay (ELISA).

RESULTS

RESULTS: Plasma HGF was elevated both in patients with CHF and T2DM as measured against healthy control group. The elevation was most prominent in patients with CHF/T2DM comorbidity and was found to correlate with HbA1c level (r=0.52, p=0.03). Plasma HGF also correlated with BMI (r=0.42, p=0007) in a unified study group, though we observed no statistically significant difference between subgroups with a trend toward higher HGF in obese patients with CHF/T2DM comorbidity (626.1?254.1 pg/ml vs 742.0?210.7 pg/ml respectively; p >0.05). Interestingly, plasma HGF was also significantly higher in controls with BMI >30 km/m2 (324.1?107.7 pg/ml vs 436.9?112.3 pg/ml, p=0.03).Circulating HGF correlated with plasma levels of N-terminal fragment of B-type natriuretic peptide (NT-proBNP) and such structural and functional myocardial characteristics as left atrial size and maximum volume along with left ventricular ejection fraction (EF), end-diastolic volume (EDV) and end-diastolic dimension (EDD).

CONCLUSION

CONCLUSION: These findings suggest that HGF may potentially serve as a prediction marker for unfavorable myocardial remodeling and poor prognosis in CHF patients with T2DM and obesity, though this possibility should be further investigated in follow-up studies.

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