The Study Of Pancreatic β-cell Dysfunction And Diabetic Cardiac Insufficiency In Type 2 Diabetes Mellitus

Objective:To investigate that Pancreaticβ-cell dysfunction leads to diabetic cardiac insufficiency related the changes of clinical features and hormone in type 2 diabetes. Not only looking for an important interventional target of diabetic cardiac insufficiency,but also providing a scientific evidence to take interventional measurement.Methods:Type 2 diabetes in 76 cases,healthy control group in 25 cases. Divided into:healthy control group in 25 cases;new type 2 diabetes and the course of type 2 diabetes＜2 yearsin 23 cases;the course of type 2 diabetes who does not have obvious clinical signs and symptoms of heart failure＞2 years in 22 cases,;the course of type 2 diabetes who has obvious clinical signs and symptoms of heart failure in 21 cases.Measurement:Serum ANP,BNP,TI,PI and FFA of all subjects were measured in ELISA,serum FPG,FINS were detemined by radioimmunoassay(RIA) technique, FPG and FINS were calculated Homa-Is=20×FINS/(FPG -3.5).Echocardiographic assessment were measured:E/A,e/a,S/D,LVEF.Results:The Homa-Is which reflects the secretory function of Pancreaticβ-cell declined significantly with the progress of type 2 diabetes;ANP and BNP were significantly increased accompaning of dysfunction of Pancreaticβ-cell;the TI and PI of course of type 2 diabetes who has obvious clinical signs and symptoms of heart failure were significantly different with other groups;the E/A,e/a,S/D and LVEF of type 2 diabetes were more reduction than the control group.According to correlation analysis,TI was correlated negatively with ANP,BNP(r=-0.346,-0.578,p＜0.05),positively with E/A,LVEF (r=0.281,0.501,p＜0.05),TI was not related to e/a,S/D;PI was correlated positively with BNP(r=0.217,p＜0.05),negatively with LVEF(r=-0.219,p＜0.05),PI was not related to ANP,e/a,E/A,S/D;Homa-Is was correlated negatively with ANP,BNP(r=-0.313,-0.440,p＜0.01),positively with S/D,LVEF(r=0.419,0.245,p ＜0.01),Homa-Is was not related to E/A,e/a.Multiple stepwise regression analysis revealed that the independent variable associated with Homa-Is were BNP,S/D(r2=0.251,p＜0.01).Conclusions:The study observed that myocardial contractility and diastolic function declined with the dysfunction of Pancreaticβ-cell in type 2 diabetes,the level of serum TI and PI which reflected function of Pancreaticβ-cell hase independent variable associated with the ANP and BNP(BNP is more sensitive than ANP in reflecting heart failure),and their clinical and echocardiographic manifest.