Expression of Toll like receptor-4 and tumor necrosis factor-α on peripheral-blood mononuclear cells and cardiac function in patients with diabetic cardiomyopathy

Objective To explore the expressions of Toll-like receptor 4(TLR4) and tumor necrosis factor(TNF)-α on peripheral-blood mononuclear cells(PBMC) and theirs correlation with cardiac function in patients with diabetic cardiomyopathy(DCM). Methods Patients admitted to Department of Cardiology of Guangdong Medical College from June 2008 to July 2011 were divided into 2 groups: group of type-2 diabetes mellitus(T2DM) (n=36), DCM group (n=48). Forty healthy check-up people were selected as the control group. All the subjects were analyzed by New York Heart Association (NYHA) functional class. To compare the expressions of TLR4, TNF-α, N-terminal -Brain natriuretic peptide(NT-BNP)and left ventricular ejection fraction(LVEF), Left ventricular end diastolic diameter(LVEDd)among three groups. Association between cardiac function and the Level of TLR4, TNF-α were analyzed by Multiple stepwise regression. Results (1)Compared with the control and T2DM groups, the expressions of TLR4 and TNF-α were upgraded, the levels of NT-BNP, LVEDd increased, and the level of LVEF decreased in DCM group (P 0.05). (4) The multiple regression analysis may predict that TLR4 was independent related factors of NYHA functional class with DCM(Regression coefficient t=0.371, P=0.000). Conclusion The TLR4/TNF-α signaling pathways is correlated positively with the severity of cardiac function in patients with DCM, and plays an important role in the progress of heart failure in DCM patients. Key words: Diabetes Mellitus type 2; Cardiomyopathy; Toll-like receptor4; Tumor necrosis factor-α