糖尿病性心肌病患者外周血单个核细胞NLPR3和NF-κB表达及与心肌灌注的相关性

孟莎莎; 李楠; 刘晓华

doi:10.16766/j.cnki.issn.1674-4152.004204

糖尿病性心肌病患者外周血单个核细胞NLPR3和NF-κB表达及与心肌灌注的相关性

doi: 10.16766/j.cnki.issn.1674-4152.004204

1.
康复大学青岛医院青岛市市立医院血管外科，山东青岛 266000
2.
康复大学青岛医院青岛市市立医院心内二科，山东青岛 266000
3.
康复大学青岛医院青岛市市立医院腔镜中心，山东青岛 266000

基金项目:

山东省医药卫生科技发展计划项目 202203010192

详细信息

通讯作者:
刘晓华，E-mail：405065168@qq.com

中图分类号: R587.2 R542.2
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出版历程
- 收稿日期: 2025-03-11

The expression of NLPR3 and NF-κB in peripheral blood mononuclear cells of patients with diabetic cardiomyopathy and their correlation with myocardial perfusion

1.
Department of Vascular Surgery, Qingdao Municipal Hospital of Rehabilitation University, Qingdao, Shandong 266000, China

摘要

摘要: 目的探讨糖尿病性心肌病(DCM)患者外周血单个核细胞核苷酸结合寡聚化结构域样受体蛋白3(NLPR3)、核转录因子KappaB(NF-κB)表达特点及其与患者心肌灌注发展的相关性。方法选取2023年6月—2024年6月康复大学青岛医院的100例糖尿病患者分为DCM组(36例)和糖尿病组(64例)，30例健康体检者为对照组。采用ROC曲线评估NLPR3、NF-κB诊断DCM的效能；采用Pearson相关性分析研究NLPR3、NF-κB与心肌灌注总运动负荷(SSS)、总静息(SRS)评分的相关性。结果 DCM组NLPR3、NF-κB表达(1.67±0.28、2.21±0.65)高于糖尿病组(1.04±0.20、1.57±0.38)，糖尿病组均高于对照组(0.76±0.10、0.75±0.10, F=172.319、91.669，P＜0.05)；NLPR3、NF-κB、联合检测诊断DCM的曲线下面积为0.963、0.847、0.990(P＜0.05)；DCM组SSS、SRS评分[(19.68±8.19)分、(13.10±4.62)分]均高于糖尿病组[(6.36±1.04)分、(5.21±1.92)分]，左心室射血分数[(34.14±15.58)%]低于糖尿病组[(53.21±8.58)%，t=12.877、11.980、7.907，P＜0.05]；DCM患者NLPR3、NF-κB表达与SSS、SRS评分呈正相关关系(r=0.449、0.367、0.353、0.401，均P＜0.05)。结论 DCM患者外周血单个核细胞NLPR3、NF-κB表达升高，可协助临床诊断DCM，可能参与心肌灌注发展过程。
- 糖尿病 /
- 糖尿病性心肌病 /
- 核苷酸寡聚化样受体 /
- 核转录因子κB /
- 心肌灌注
Abstract: Objective To explore nucleotide-binding oligomerization domain-like receptor protein 3(NLPR3) in peripheral blood mononuclear cells of patients with diabetic cardiomyopathy (DCM) Expression characteristics of nuclear transcription factor KappaB(NF-κB) and its correlation with myocardial perfusion development in patients. Methods A total of 100 patients with diabetes admitted to Qingdao Hospital of University of Health and Rehabilitation Sciences from June 2023 to June 2024 were enrolled and divided into a DCM group and a diabetes group. An additional 30 healthy individuals undergoing physical examinations were selected as the control group. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of NLPR3 and NF-κB expression in DCM. Pearson correlation was used to analyze the correlation between NLPR3 and NF-κB expression with summed stress score (SSS score) and summed rest score (SRS score) on myocardial perfusion. Results The expressions levels of NLPR3 and NF-κB in the DCM group (1.67±0.28, 2.21±0.65) were higher than those in the diabetes group (1.04±0.20, 1.57±0.38), and both were elevated relative to the control group (0.76±0.10, 0.75±0.10; F=172.319, 91.669, P < 0.05). The areas under the curve of NLPR3, NF-κB, and their combined detection for diagnosing DCM were 0.963, 0.847, and 0.990, respectively (P < 0.05). The SSS and SRS scores of the DCM group (19.68±8.19, 13.10±4.62) were both higher than those in the diabetes group (6.36±1.04, 5.21±1.92), while the LVEF [(34.14±15.58) %] was lower than that in the diabetes group [(53.21±8.58)%, t=12.877, 11.980, 7.907, P < 0.05]. The expressions of NLPR3 and NF-κB in patients with DCM were positively correlated with SSS and SRS scores (r=0.449, 0.367, 0.353, 0.401, P < 0.05). Conclusion NLPR3 and NF-κB are upregulated in peripheral blood mononuclear cells of DCM patients, and their expression is closely associated with impaired myocardial perfusion. These markers can assist the clinical diagnosis of DCM and provide insights into the pathophysiological mechanisms of DCM.
- Diabetes mellitus /
- Diabetic cardiomyopathy /
- Nucleotide-binding oligomerization domain-like receptor /
- Nuclear factor KappaB /
- Myocardial perfusion
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图 1 外周血单个核细胞NLPR3、NF-κB表达诊断糖尿病患者合并DCM的ROC曲线

Figure 1. ROC curve analysis of NLRP3 and NF-κB expression in peripheral blood mononuclear cells for diagnosing DCM in diabetic patients

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表 1 2组糖尿病患者和健康对照组临床资料比较

Table 1. Comparison of clinical data between two groups of diabetic patients and the healthy control group

组别	例数	性别[例(%)]		年龄(x ±s，岁)	BMI (x ±s)	收缩压(x ±s，mmHg)	舒张压(x ±s，mmHg)
组别	例数	男性	女性	年龄(x ±s，岁)	BMI (x ±s)	收缩压(x ±s，mmHg)	舒张压(x ±s，mmHg)
DCM组	36	20(55.56)	16(44.44)	56.84±5.61	20.38±1.32	125.80±10.49	78.34±7.38
糖尿病组	64	33(51.56)	31(48.44)	56.03±5.85	20.10±1.25	122.91±10.50	76.74±8.40
对照组	30	16(53.33)	14(46.67)	55.24±5.38	19.95±1.45	123.38±11.36	77.34±7.69
统计量		0.149^a		0.653^b	0.939^b	0.873^b	0.464^b
P值		0.928		0.522	0.394	0.420	0.630
注：^a为χ²值，^b为F值；1 mmHg=0.133 kPa。

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表 2 2组糖尿病患者和健康对照组外周血单个核细胞NLPR3、NF-κB表达比较(x ±s)

Table 2. Comparison of NLPR3 and NF-κB expressions in peripheral blood mononuclear cells between the diabetic group and the healthy control group(x ±s)

组别	例数	NLPR3	NF-κB
DCM组	36	1.67±0.28^ab	2.21±0.65^ab
糖尿病组	64	1.04±0.20^b	1.57±0.38^b
对照组	30	0.76±0.10	0.75±0.10
F值		172.319	91.669
P值		＜0.001	＜0.001
注：与糖尿病组比较，^aP < 0.05；与对照组比较，^bP < 0.05。

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表 3 外周血单个核细胞NLPR3、NF-κB表达对DCM的预测价值分析

Table 3. Predictive value of NLRP3 and NF-κB expression in peripheral blood mononuclear cells for DCM

指标	最佳截断值	约登指数	灵敏度(%)	特异度(%)	SE	AUC	95% CI	P值
NLPR3	1.25	0.835	94.00	89.00	0.021	0.963	0.904~0.990	＜0.001
NF-κB	1.81	0.583	83.00	75.00	0.043	0.847	0.761~0.911	＜0.001
联合检测		0.913	94.00	96.00	0.007	0.990	0.945~1.000	＜0.001

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表 4 2组糖尿病患者心肌灌注指标比较(x ±s)

Table 4. Comparison of myocardial perfusion indicators between two groups of diabetic patients(x ±s)

组别	例数	SSS(分)	SRS(分)	LVEF(%)
DCM组	36	19.68±8.19	13.10±4.62	34.14±15.58
糖尿病组	64	6.36±1.04	5.21±1.92	53.21±8.58
t值		12.877	11.980	7.907
P值		＜0.001	＜0.001	＜0.001

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表 5 DCM患者外周血单个核细胞NLPR3、NF-κB表达与心肌灌注指标的相关性

Table 5. Correlation between NLRP3 and NF-κB expression in peripheral blood mononuclear cells and myocardial perfusion indicators in patients with DCM

项目		NLPR3	NF-κB
SSS	r值	0.449	0.353
	P值	＜0.001	0.010
SRS	r值	0.367	0.401
	P值	0.003	＜0.001

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