老年冠心病患者血浆网膜素1及内脂素水平分析
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湖南省自然科学基金课题(12JJ5044)


Analysis of the Plasma Levels of Omentin-1 and Visfatin in Senile Coronary Heart Disease Patients
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    摘要:

    目的 观察老年冠心病患者血浆网膜素1、内脂素水平的变化,并探讨其临床意义。方法 采用酶联免疫吸附法测定59例老年冠心病患者(年龄≥60岁;冠心病组)及31例健康者(年龄≥60岁;对照组)的血浆网膜素1、内脂素浓度。依据临床症状将冠心病组分为2个亚组:稳定型心绞痛(SAP)组29例,不稳定型心绞痛(UAP)组30例;依据NYHA心功能分级将冠心病组分为3个亚组:即心功能Ⅰ级组11例,心功能Ⅱ、Ⅲ级组36例,心功能Ⅳ级组12例。结果 (1)冠心病组血浆网膜素1水平显著低于对照组(717.63±229.11 ng/L比1115.49±361.41 ng/L,P=0.000);SAP组、UAP组均显著低于对照组(780.32±273.19 ng/L比1115.49±361.41 ng/L,652.81±152.94 ng/L比1115.49±361.41 ng/L,均P<0.05)。(2)冠心病组血浆内脂素水平显著高于对照组(19.22±6.73 μg/L比13.31±1.69 μg/L,P=0.002),且SAP组、UAP组显著高于对照组(17.92±4.19 μg/L比13.31±1.69 μg/L,20.43±8.31 μg/L比13.31±1.69 μg/L,均P<0.05)。(3)心功能Ⅰ级组、Ⅱ和Ⅲ级组、Ⅳ级组,血浆网膜素1水平(1033.87±277.84 ng/L、676.58±137.25 ng/L、540.35±59.49 ng/L)逐渐下降,内脂素水平(13.00±1.19 μg/L、19.08±2.97 μg/L、25.23±11.30 μg/L)逐渐升高,3组之间比较这两项指标均有显著差异(均P<0.05)。(4)血浆网膜素1水平与收缩压呈显著负相关(r=-0.264,P=0.041),与血浆高密度脂蛋白胆固醇(HDLC)水平呈显著正相关(r=0.271,P=0.038);血浆内脂素水平与总胆固醇呈显著正相关(r=0.292,P=0.025),与HDLC水平呈显著负相关(r=-0.266,P=0.039)。(5)血浆网膜素1与内脂素水平之间呈显著负相关(r=-0.280,P=0.032);多元线性逐步回归分析显示网膜素1、内脂素均可能受HDLC水平的影响;Logistic回归分析显示在冠心病的发生中内脂素可能是危险因素。结论 (1)网膜素1水平的降低及内脂素水平的升高均可能参与了冠心病的发生发展过程。(2)网膜素1与内脂素可能分别为保护因子及致炎因子,且均可能与脂代谢有关。(3)内脂素是冠心病发生的独立危险因素。

    Abstract:

    Aim To investigate the alteration of plasma levels of omentin-1, visfatin in old patients with coronary heart disease (CHD) and to explore its clinical significance. Methods Plasma omentin-1, visfatin levels were measured in 90 subjects [29 stable angina pectoris (SAP) cases, 30 unstable angina pectoris (UAP) cases and 31 age-and sex-matched healthy controls, age≥60years] using enzyme-linked immunosorbent assay (ELISA) methods. According to the NYHA classification, 59 CHD were divided into three groups: functional Ⅰ class for 11 cases, functional Ⅱ/Ⅲ class for 36 cases, functional Ⅳ class for 12 cases. Results (1)The plasma level of omentin-1 in coronary heart disease patients was significantly lower than that of the control group(717.63±229.11 ng/L vs 1115.49±361.41 ng/L, P=0.000), and SAP group’s, UAP group’s were all significantly lower than control group (respectively 780.32±273.19 ng/L vs 1115.49±361.41 ng/L, 652.81±152.94 ng/L vs 1115.49±361.41 ng/L, all P<0.05). (2)The plasma level of visfatin in CHD patients was significantly higher than the control group (19.22±6.73 μg/L vs 13.31±1.69 μg/L, P=0.002), the level of visfatin of SAP group and UAP group were all significantly higher than that of the control group (17.92±4.19 μg/L vs 13.31±1.69 μg/L, 20.43±8.31 μg/L vs 13.31±1.69 μg/L, respective, all P<0.05). (3)With the increase of NYHA class, the plasma omentin-1 level decreased, while visfatin levels increased gradually, and among the three groups, there were significant differences (omentin-1 respectively 1033.87±277.84 ng/L, 676.58±137.25 ng/L, 540.35±59.49 ng/L, visfatin respectively 13.00±1.19 μg/L, 19.08±2.97 μg/L, 5.23±11.30 μg/L, all P<0.05). (4)The plasma omentin-1 level was negative correlated with systolic blood pressure (SBP) (r=-0.264, P<0.05), positively correlated with high density lipoprotein cholesterol (HDLC) level (r=0.271, P<0.05).

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王小清,窦灵芝,王秀华.老年冠心病患者血浆网膜素1及内脂素水平分析[J].中国动脉硬化杂志,2014,22(06):579~586.

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  • 收稿日期:2013-06-05
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