人血清卵泡抑素样蛋白1与器质性心脏病左心室重构程度的相关性研究  

Correlation between serum follistatin-like 1 and left ventricular remodeling in patients with organic heart disease

作　　者：张芃[1] 郑哲[1] 魏英杰[1] 胡盛寿[1] 高一鸣[1] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院外科,100037

出　　处：《心肺血管病杂志》2010年第3期169-173,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：长江学者和创新团队发展计划和中央级公益型科研院所基本科研业务费;国家科技支撑计划(2006BAI01A09);北京市科委重点计划(D0906004040391)

摘　　要：目的:卵泡抑素样蛋白1(FSTL-1)是近年发现的有前景的心血管疾病血清标记物。探讨人血清FSTL-1水平是否与左心室重构程度具有相关性。方法:入选瓣膜性心脏病和冠心病患者156例。收集患者临床资料。采集外周静脉血,检测血清FSTL-1水平。通过超声心动测定左心室舒张末径、左心室质量指数(LVMI)、左心室相对室壁厚度等左心室重构指标。通过统计学分析FSTL-1水平与心血管疾病危险因素、生化指标及左心室重构指标的相关性。结果:FSTL-1水平与左心室舒张末径(r=0.444,P<0.001)、LVMI(r=0.438,P<0.001)呈显著正相关;与左心室射血分数(r=-0.236,P=0.004)、左心室相对室壁厚度(r=-0.244,P=0.003)呈显著负相关。多元线性回归分析示,控制了年龄、性别、心血管危险因素和生化指标后,FSTL-1水平仍与LVMI呈显著正相关(偏回归系数β=0.635,P=0.002)。ROC曲线分析表明,FSTL-1是左心室肥大的血清标记物(AUC=0.707,95%CI为0.596～0.812,P=0.001)结论:血清FSTL-1水平与左心室重构程度呈独立、显著的相关性。为FSTL-1作为心血管疾病血清标记物应用于临床提供了病理生理基础。Background：Follistatin-like 1（FSTL-1）,once referred to as TSC-36 or follistatin-related protein（FRP）,is a 308-amino acid secretory glycoprotein and is a divergent member of follistatin family of proteins.FSTL-1 is emerging as an independent prognostic biomarker in patients with cardiovascular disease.Objective：We hypothesized that serum levels of FSTL-1 were associated with the extent of left ventricular（LV） remodeling.Methods：To relate levels of FSTL-1 to indices of LV remodeling and function,serum levels of FSTL-1,high sensitivity-C reactive protein（hs-CRP） and amino-terminal pro-brain natriuretic peptide（NTproBNP） were measured in 156 patients with diagnosed valvular or coronary heart disease.The left ventricular remodeling was assessed by echocardiography,measuring left ventricular end-diastolic diameter（LVEDD）,left ventricular mass index（LVMI） and relative wall thickness（RWT）.Results：Levels of FSTL-1 were related to LVEDD（r = 0.444,P 0.001）,LVMI（r = 0.438,P 0.001）,RWT（r =-0.244,P = 0.003） and ejection fraction（r =-0.236,P = 0.004）.The positive association between FSTL-1 and LVMI remained significant in a multivariate regression model adjusted for age,sex,conventional CV risk factors and established biomarkers,including NT-proBNP and hs-CRP（unstanderdized β = 0.635,P = 0.002）.Receiver operating characteristic curve analysis further illustrated that FSTL-1 was a strong marker of LV hypertrophy（area under the curve 0.707,95% CI 0.596 to 0.812）.Serum levels of FSTL-1 were related to increasing NYHA levels（P =0.008 for trend）.Moreover,serum levels of FSTL-1 were significantly correlated with serum levels of NT-proBNP（r = 0.479,P 0.001） and high sensitivity-CRP（r = 0.170,P = 0.048）.Conclusion：Serum levels of FSTL-1 were independently associated with LVMI in patients with valvular and coronary heart disease,demonstrating that FSTL-1 is involved in LV remodeling and could be applied as a cardiovascular biomarker.

关 键 词：卵泡抑素样蛋白1 生物标记物 心室重构 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]