血浆脂联素水平下降与2型糖尿病合并慢性稳定性心绞痛患者冠状动脉病变的严重性相关  

Relationship between Decreased Plasma Adiponectin and Severity of Coronary Artery Lesions in Patients with Type-2 DM and Chronic Stable Angina Pectoris

作　　者：童国新[1,2] 王宁夫[1,2] 杨俊[1,2] 来蕾[1,2] 冷建杭[1,2] 叶显华[1,2] 周亮[1,2] 杨建敏[1,2] 

机构地区：[1]杭州市第一人民医院心内科 [2]南京医科大学附属杭州医院,310006

出　　处：《医学研究杂志》2011年第1期73-77,共5页Journal of Medical Research

基　　金：浙江省医药卫生科学研究基金(2007A157)

摘　　要：目的研究血浆脂联素水平与2型糖尿病合并慢性稳定性心绞痛(DM-SAP)患者冠状动脉病变严重程度的关系。方法 236例DM-SAP患者的诊断依靠冠状动脉造影确诊,采用Gensini积分计算方法评价冠脉病变的严重程度,并根据Gensini积分四分位数分成4组,另外选取138例健康体检者作为阴性对照组。所有研究对象均采用ELISA法测定血浆脂联素水平,以免疫比浊法测定血清hs-CRP水平。结果 DM-SAP组血浆脂联素水平较阴性对照组明显降低(6.51±1.97μg/ml:7.55±1.63μg/ml,P<0.001)。较高Gensini积分四分位组(组4、3和2)的DM-SAP患者其血浆脂联素水平明显低于最低四分位组(组1)(P<0.001)。DM-SAP患者脂联素水平与当前吸烟、HbA1c水平呈显著负相关(P<0.05)。多因素Logistic回归分析显示,低脂联素水平是DM-SAP患者冠脉病变严重程度的独立危险因素(OR=17.78,95%CI 6.453～49.01,P<0.001)。结论血浆脂联素水平随着2型糖尿病合并慢性稳定性心绞痛冠脉病变的严重性显著下降,表明血浆脂联素水平下降可能参与了动脉粥样硬化的病理过程。Objective To investigate the relationship between plasma adiponectin level and the severity of coronary artery lesions in patients with type-2 DM and chronic stable angina pectoris（DM-SAP）.Methods 236 DM-SAP patients were diagnosed by coronary angiography,and the severity of coronary artery lesions was measured by Gensini score,then the DM-SAP patients were assigned into 4 groups according to the quartile of Gensini score,and a healthy control group（n=138） was established.Plasma adiponectin concentrations in all subjects were measured by ELISA,and serum Hs-CRP levels were measured by immunoturbidimetry.Results Adiponectin level in DM-SAP group was lower than that in control group（6.51±1.97μg/ml vs 7.55±1.63μg/ml,P0.001）.Adiponectin levels in the higher Gensini scores quartile groups（group 4,group 3 and group 2） were significantly lower than those in the lowest quartile group（group 1）（P0.001）.There was significant negative correlation between plasma adiponectin level and current smoking or HbA1c（P0.05）.Multivariate logistic regression analysis demonstrated that decreased adiponectin level was the significant independent risk factor of the severity of coronary artery lesions in patients with DM-SAP（OR=17.78,95%CI 6.453 to 49.01,P0.001）.Conclusion Plasma adiponectin level decreased markedly with the severity of coronary artery lesions in patients with type-2 DM and chronic stable angina pectoris,which suggested that decreased plasma adiponectin may be involved in the pathogenesis of atherosclerosis.

关 键 词：脂联素 2型糖尿病 慢性稳定性心绞痛 GENSINI积分 

分 类 号：R972[医药卫生—药品]