冠心病合并代谢综合征患者血浆脂联素和Apelin的水平及临床意义  

Clinical significance of plasma adiponectin and apelin in coronary disease patients accompanied with metabolic syndrome

作　　者：郭兰燕[1] 夏珂[1] 程晋芳[1] 李非[1] 杨天伦[1] 

机构地区：[1]中南大学湘雅医院心血管内科,长沙410008

出　　处：《临床内科杂志》2011年第6期379-382,共4页Journal of Clinical Internal Medicine

摘　　要：目的研究冠心病并代谢综合征患者血浆脂肪细胞因子脂联索和Apelin含量的变化及临床意义。方法选择75名住院的冠心病患者，其中合并代谢综合征（MS）者（CM组）35例，单纯冠心病患者（C组）40例，均行冠脉造影检查，并计算相应的Gensini积分；选择同期体检者62例，其中患有MS者（M组）29例，健康者（N组）33例。检测血脂、空腹血糖（FBG）、空腹胰岛素（FIN）、超敏C反应蛋白、游离脂肪酸，Apelin和脂联素；计算BMI、胰岛素抵抗指数（HOMA—IR）并进行比较。结果CM组、c组和M组的患者血浆脂联素和Apelin浓度均低于N组（P均〈0．05），其中CM组的脂联素较C组和M组低（P〈0．05），Apelin的水平介于C组和M组之间（P〈0．05）。直线相关分析显示，脂联素与HDL—C显著正相关（P〈0．01），与超敏C反应蛋白、SBP、DBP、甘油三酯、腰围、BMI（P均〈0．01）和尿酸、FIN、HOMA—IR（P均〈0．05）成负相关；Apelin与HDL—C显著正相关（P〈0．01），与SBP、DBP、甘油三酯、尿酸、BMI和腰围成负相关（P均〈0．05）。在冠心病患者中，脂联素与Gensini积分呈负相关（P〈0．05），而Apelin与之无明显相关性（P〉0．05）。结论冠心病并MS患者血浆脂联素水平显著降低，而Apelin的水平介于冠心病和MS之间，其水平更易受代谢成分的影响，不能像脂联素那样较好地反映和评估冠心病伴MS患者的病情严重程度。Objective To investigate the level and clinical significance of plasma Adiponectin and Apelin in coronary artery disease（CAD） patients accompanied with metabolic syndrome（MS）. Method CAD was confirmed by coronary artery angiography in 75 patients who were admitted into Yangya hospital,and the according Gensini score was figured out. Metabolic syndrome was diagnosed in 35 out of 75 CAD patients （CM group）, the rest was enrolled in C group. Meanwhile, 62 people were collected among the healthy examined people, and metabolic syndrome was diagnosed in 29 out of 62subjects （M group） ,and the rest was in N group. All subjects received detection of height, weight, BMI, blood lipid, fasting blood glucose （ FBG ）, fasting insulin （ FIN ）, hs-CRP, Apelin and Adiponectin （ ELISA ）. The degree of insulin resistance was assessed by the homeostasis model assessment insulin resistance index（ HOMA- IR）. Result Compared with group N,the levels of Adiponectin and Apelin in the groups of CM,C and M decreased significantly（ all P 〈0.05 ）. The level of Adiponectin was lower in group CM than in group C and M （ P 〈 0.05 ）, the levels of Apelin were lower in group C than in group CM and M （ P 〈 0.05 ）. Apelin/Adiponectin was positively correlated with HDL-C and negatively with triglyceride （TG） , uric acid （UA） ,body mass index （ BMI）, waist circumference （ WC ）, systolic blood pressure （SBP） and diastolic blood pressure （DBP）. Also, Adiponectin was negatively correlated with hs-CRP, fast insulin （ FIN ）, HOMA-IR and Gensini score （ all P 〈 0.05 ）. Conclusion Plasma Adiponectin decreased most signifi- cantly in group of CAD patients accompanied with MS, while Apelin was lower than the CAD and higher than the MS. Since Apelin was often affected by metabolic factors,it couldn＇ t exactly evaluate and reflect the disease severity in patients of CAD accompanied with MS like Adiponectin.

关 键 词：冠状动脉疾病 代谢综合征 脂联素 APELIN 

分 类 号：R541.4[医药卫生—心血管疾病] R58[医药卫生—内科学]