葡萄糖调节受损的冠心病患者血清瘦素/脂联素比值与冠状动脉狭窄的关系  

Relationship between serum leptin-to-adiponectin ratio and coronary artery stenosis in patients with coronary heart disease and impaired glucose regulation

作　　者：乔增勇[1] 马江伟 刘化进[1] 曹华[1] 张立[1] 陶元[1] 葛广豪[1] 杨栓锁[1] 朱翠清[1] 熊三军[1] 王宏伟[1] 凤敏华[2] 

机构地区：[1]上海交通大学附属六院南院心内科,上海市201200 [2]上海交通大学附属六院南院核医学科,上海市201200

出　　处：《中国心血管病研究》2015年第10期889-892,共4页Chinese Journal of Cardiovascular Research

基　　金：上海市奉贤区科学技术委员会基金（项目编号：F2013156）

摘　　要：目的 探讨冠心病（CHD）合并葡萄糖调节受损（IGR）患者血清中瘦素/脂联素比值与冠状动脉狭窄程度间的关系.方法 经冠状动脉造影确诊CHD合并IGR的患者150例为观察组,另外150例冠状动脉造影确诊CHD但无IGR的患者作为对照组,分别测量患者身高、体重、体重指数（BMI）、腰臀比（WHR）、血压,检测患者血糖、血脂、C反应蛋白（CRP）、脂联素、瘦素,并进行Gensini评分.结果 两组患者身高、体重、吸烟、血压、血脂方面比较未见统计学差异（P＞0.05）,观察组的BMI、WHR、BG、CRP、瘦素、瘦素/脂联素显著高于对照组（P＜0.05）.观察组Gensini评分0～19分、20～39分和≥40分各组患者BMI比较未见统计学差异,WHR、血清CRP、瘦素、脂联素、瘦素/脂联素比较差异有统计学意义（P＜0.05）.Spearman相关分析显示,脂联素与WHR、Gensini评分、瘦素呈负相关（r分别为-0.491,-0.426,-0.418,P均＜0.05）,瘦素与WHR、Gensini评分呈正相关（r分别为0.417,0.398,P均＜0.05）;Gensini评分与CRP、瘦素、瘦素/脂联素呈正相关（r分别为0.399,0.286,0.312,P均＜0.05）,与脂联素呈负相关（r=-0.223,P＜ 0.05）.结论 葡萄糖调节受损的冠心病患者血清瘦素/脂联素比值与冠状动脉狭窄程度具有较好的相关性,可以用于预测IGR患者的冠脉病变程度,在临床上值得推广.Objective To investigate the relationship between serum leptin-to-adiponectin ratio and the degree of coronary artery stenosis in impaired glucose regulation patients with coronary heart disease （CHD）. Methods 150 patients with IGR and CHD diagnosed by coronary angiography were assigned to observation group, other 150 CHD patients without IGR were assigned to control group. Height, weight, body mass index（BMI）, waist-to-hip ratio （WHR） and blood pressure were measured respectively. Meanwhile, blood sugar, blood lipid, CRP, adiponeetin and leptin level were measured. The degree of coronary artery stenosis was evaluated by Gensini score. Results There was no significant difference in height, weight, smoking, blood pressure and blood lipid among patients of two groups （P〉0.05）. BMI, WHR, BG, CRP, leptin, leptin and adiponectin in observation group were significantly higher than those of control group（P〈0.05 ）. There was no statistically significant difference in BMI among patients grouped by Gensini score 0-19, 20 to 39 and t〉40 minutes in observation group. WHR, serum CRP, leptin, adiponectin, leptin-to-adiponectin ratio were significantly different in two groups （P〈0.05）. Spearman correlation analysis showed that adiponectin was negatively correlated with WHR, Gensini score and leptin（r=-0.491 ,-0.426,-0.418 respectively, P〈0.05）, leptin was positively correlated with WHR, Gensini score （r =0.417,0.398 respectively, P 〈0.05）. Gensini score was positively Correlated with CRP, leptin, leptin -to - adipenectin ratio （r=0.399,0.286,0.312 respectively, P〈0.05）, and negatively correlated with adipenectin （r= 0.223, P〈0.05 ）. Conclusion There was a better correlation between serum leptin-to-adiponectin ratio and the degree of coronary artery stenosis in patients with coronary heart disease and impaired glucose regulation, which could be used to predict the extent of coronary artery lesions in IGR patients and is of worthy in clinical practice.

关 键 词：葡萄糖调节受损 冠状动脉疾病 瘦素/脂联素 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]