Relationship Of Serum Galectin-3 And Cardiovascular Events In Diabetic Kidney Disease Patients

Objective:To study the correlation between serum galectin-3(Gal-3)level,and several cardiovascular risk factors,cardiac structure and function in diabetic kidney disease(DKD)patients.To further explore the relationships between serum Gal-3 and cardiovascular events in DKD patients.To provide a new train of thought for the clinical diagnosis and treatment of DKD patients who prone to cardiovascular events.Methods:A total of 66 DKD patients with renal medicine in hospital who were not dialysis and whose urinary albumin creatinine ratio(ACR)>30 mg/g were included in the present study between Oct 2016 and Apr 2017.30 patients with microalbuminuria(30mg/g?ACR<300mg/g)and 36 patients with a large number of albuminuria(ACR?300mg/g).And 20 patients with type 2 diabetes and 20 healthy people were enrolled in the study.Serum Gal-3 was measured by ELISA.DKD patients were categorized into four groups according to the quartiles of Gal-3:group?(Gal-3<71.87 pg/ml),group?(71.87 pg/ml?Gal-3<79.51 pg/ml),group?(79.51 pg/ml?Gal-3<122.11 pg/ml),group?(Gal-3?122.11pg/ml).All patients were examined by transthoracic echocardiography to measure and calculate left atrial diameter(LAD),left ventricular diameter at the end of diastole(LVDd),posterior wall of left ventricle(LVPW),interventricular septum(IVS),left ventriclar mass(LVM),left ventriclar mass index(LVMI),ejection fraction(LVEF),the ratio of the early(E)to late(A)ventricular filling velocities(E/A ratio).At the same time the patient's clinical data and blood biochemical indexes were collected.Interrelations among above parameters were examined statistically.Results:A total of 106 patients were enrolled,and the serum gal-3 level of all patients was fluctuated at 28.72~387.58pg/ml,and the average level of serum gal-3 in DKD patients was higher than that of serum gal-3 in patients of control group.Compared with control group,the change of diabetes duration(DD),serum creatinine(Scr)and estimated glomerular filtration rate(eGFR)was statistically significant in DKD patients(P<0.05).Among them,66 patients were included in DKD,and single factor correlation analysis showed that serum gal-3 level of DKD patients had positive correlation with the combined hypertension(r=0.297,P=0.015),SBP(r=0.531,P<0.001),LDL-C(r=0.257,P=0.037),UA(r=0.405,P=0.001),Scr(r=0.388,P=0.001),HbA1c(r=0.283,P=0.021),ACR(r=0.522,P<0.001),BNP(r=0.753,P<0.001),cTnI(r=0.565,P<0.001)and had negative correlation with eGFR(r=-0.519,P<0.001).Gal-3 as the dependent variable,and factors who correlated with serum levels of Gal-3 as independent variables,according to the results of multiple stepwise regression analysis,cTnI and BNP are the main factors influencing the level of serum Gal-3(determination coefficient R~2=0.618).Moreover,with elevated serum Gal-3 levels,LAD,LVDd,LVPW,IVS,LVM,LVMI andLVH%weresignificantlyincreased(P<0.05),andLVEFdropped significantly(P<0.05).The single factor correlation analysis showed that the serum Gal-3 levels of patients with DKD had positive correlation with LAD(r=0.349,P<0.05),LVDd(r=0.472,P<0.05),LVPW(r=0.398,P<0.05),LVM(r=0.567,P<0.05),LVMI(r=0.227,P<0.05),LVH%(r=0.215,P<0.05)and had negative correlation with LVEF(r=-0.389,P<0.05).Conclusions:The level of serum Gal-3 is not only associated with several cardiovascular risk factors such as thr proportion of combined hypertension,SBP,BNP,cTnI,HbA1c,LDL-C,UA,Scr,ACR,eGFR,but associated with the indicators related to cardiac structure and function such as LAD,LVDd,LVPW,LVM,LVMI,LVH and LVEF in DKD patients.Gal-3 may be a risk factor to predict cardiovascular events happen in DKD patients.