瘦素水平与冠心病及其相关危险因素的关系  

Relationship between plasma level of leptin and the risk factors of coronary heart disease

作　　者：卢桂静[1] 李方雄[1] 张国刚[1] 杨天伦[1] Berglund L 

机构地区：[1]中南大学湘雅医院心内科,长沙市410008 [2]University of California, Davis

出　　处：《中华老年医学杂志》2008年第3期168-170,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨血浆瘦素水平与冠心病及其相关危险因素的关系。方法对533例患者进行了冠状动脉造影，其中冠心病稳定性心绞痛组（SAP）282例，对照组251例，测定其血浆瘦素水平，分析冠心病的危险因素与瘦素水平的关系。结果瘦素水平SAP组为（16．8±15．1）mg／L，对照组为（13．1±12．5）mg／L，两组之间差异有统计学意义（P〈0．01）；男性（8．6±8．8）mg／L、女性（23．4±14．8）mg／L，差异有统计学意义（P〈0．01）；瘦素水平与体质指数（BMI）（r=0．55，P〈0．01）、Ⅶ因子（r=0．27，P〈0．01）、三酰甘油（r=0．096，P〈0．05）、总胆固醇（r=0．182，P〈0．01）、低密度脂蛋白胆固醇（r=0．155，P〈0．01）、超敏C反应蛋白（hs—CRP）（r=0．135，P〈0．01）、纤维蛋白原（r=0．227，P〈0．01）、胰岛素（r=0．103，P〈0．05）、胰岛素抵抗指数（r=0．262，P〈0．01）呈正相关；与高密度脂蛋白胆固醇（HDL-C）（r=-0．106，P〈0．05）呈负相关。进入回归方程的因素为BMI、hs—CRP、Ⅶ因子、胰岛素、HDL-C。结论增高的瘦素水平可能与冠心病的发病密切相关，血清瘦素水平可作为冠心病的独立危险因素。Objective To investigate the relationship between plasma level of leptin and the risk factors of coronary heart disease （CHD）. Methods Five hundred and thirty-three patients underwent elective coronary angiography in a cohort study,including 282 patients with stable angina pectoris（SAP） and 251 subjects served as normal control. Plasma level of leptin and traditional CHD risk factors were measured. Results Plasma leptin level in SAP group was significantly higher than in control group [（16.8±15.1）mg/L vs. （13.1±12.5）mg/L,P〈0.01]. Plasma leptin levels were significantly lower in male group than in female group[（8. 6±8. 8）mg/L vs. （23.4±14.8）mg/L,P 〈0. 01], and leptin level was correlated positively with body mass index（BMI） （r=0. 55, P〈0.01）, factor （r=0. 27,P〈0. 01）, tri-glycerides （TG） （r=0. 096, P〈0. 05）, total cholesterol （TC）（r = 0. 182, P 〈 0. 001 ） ; low-density lipoprotein cholesterol （LDL-C） （r = 0. 155, P 〈 0. 01 ） ; high sensitive C-reactive protein（hs-CRP） （r = 0.135, P〈0.01 ） ; fibrinogen（ r = 0.227, P〈 0. 001 ） ; insulin（ r =0. 103,P〈0.05） ; HOMA-IR（r= 0. 262, P〈0. 01）, and negatively with high-density lipoprotein cholesterol （HDL-C） level （r=-0. 106, P〈0.01）. The multiple stepwise regression analysis of plasma leptin level showed that BMI, hs-CRP, factor Ⅶ, insulin and HDL entered the regression equation. Conclusions These results suggest that the increased leptin level may be involved in the pathogenesis of CHD. The leptin level is an independent risk factor for CHD.

关 键 词：瘦素 冠状动脉疾病 危险因素 脂类 

分 类 号：R686[医药卫生—骨科学]