Increased plasma serotonin metabolite 5-hydroxyindole acetic acid concentrations are associated with impaired systolic and late diastolic forward flows during cardiac cycle and elevated resistive index at popliteal artery and renal insufficiency in type 2 diabetic patients with microalbuminuria

Endocrine Journal

Eiji Suzuki³  Jun Saito³  Yukio Horikawa¹  Yoshitaka Tajima³  Jun Takeda¹  Kazuhisa Takami² 

[1] Department of Diabetes and Endocrinology, Gifu University School of Medicine, Gifu 501-1194, Japan;Department of Internal Medicine, Kizawa Memorial Hospital, Minokamo 505-8503, Japan;Department of Diabetes and Endocrinology, Gifu Prefectural General Medical Center, Gifu 500-8717, Japan

关键词: Lower extremity arterial disease;    5-hydroxyindole acetic acid;    Flow components during cardiac cycle;    Peripheral vascular resistance;    Renal insufficiency;   

DOI  :  10.1507/endocrj.EJ15-0343

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(35)Although lower extremity arterial disease is frequently accompanied by diabetes mellitus, the association of circulating biomarkers with flow components during the cardiac cycle in lower-leg arteries has yet to be fully elucidated.We enrolled 165 type 2 diabetic patients with normal ankle-brachial index (ABI 1.0-1.4), comprising 106 normoalbuminuric and 59 microalbuminuric patients, and 40 age-matched nondiabetic subjects consecutively admitted to our hospital.Serum high sensitivity C-reactive protein (hsCRP) level and plasma von Willebrand factor ristocetin cofactor activity (VWF) and vasoconstrictor serotonin metabolite 5-hydroxyindole acetic acid (5-HIAA) concentrations were measured.An automatic device was used to measure ABI and brachial-ankle pulse wave velocity (baPWV).Flow components during the cardiac cycle, total flow volume, and resistive index at popliteal artery were evaluated using gated magnetic resonance imaging.Although estimated glomerular filtration rate (eGFR), early diastolic flow reversal, heart rate, and ABI were similar between the groups, diabetic patients had higher log hsCRP (p<0.001), VWF (p<0.001), 5-HIAA (p=0.002), resistive index (p<0.001) and baPWV (p<0.001) and lower systolic (p=0.026) and late diastolic (p<0.001) forward flows and total flow volume (p<0.001) than nondiabetic subjects.Multivariate analyses demonstrated that 5-HIAA in microalbuminuric patients showed higher associations with systolic and late diastolic forward flows during the cardiac cycle, total flow volume and resistive index at popliteal artery, and eGFR compared to normoalbuminuric patients.In microalbuminuric patients, 5-HIAA was a significant independent determinant among these factors.Thus, increased plasma 5-HIAA levels are involved in the pathogenesis of impaired blood flow in lower extremities and renal insufficiency in diabetic patients with microalbuminuria.

【 授权许可】

Unknown