血清Irisin水平与肱-踝动脉脉搏波传导速度、踝臂指数相关性分析  

Associations of Serum Irisin Level With Brachial Ankle Pulse Wave Velocity and Ankle Brachial Index in Hospitalized Patients

作　　者：宋昌鹏 伍熙 郭颖[1] 郑欣馨[1] 鲁洁[1] 房晓楠[1] 黄晓红[1] SONG Chang-peng;WU Xi;GUO Ying;ZHENG Xin-xin;LU Jie;FANG Xiao-nan;HUANG Xiao-hong(Department of Cardiology, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing （100037）, China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院特需中心18病区,北京市100037 [2]中南大学湘雅三医院

出　　处：《中国循环杂志》2018年第5期476-480,共5页Chinese Circulation Journal

基　　金：中央保健课题"高龄非瓣膜性心房颤动患者长期应用达比加群抗凝治疗的安全性研究"(2014-ZYB01)

摘　　要：目的:研究血清Irisin水平与肱-踝动脉脉搏波传导速度(Ba-PWV)、踝臂指数的相关性。方法:入选阜外医院147例住院患者。应用自动分析仪测定Ba-PWV及肱动脉和踝动脉收缩压,计算踝臂指数。采用酶联免疫吸附(ELISA)方法检测患者血清Irisin水平。依据Ba-PWV将入组患者分为Ba-PWV较高组(n=93,Ba-PWV≥1 400 cm/s)和Ba-PWV较低组(n=54,Ba-PWV<1 400 cm/s);依据踝臂指数将入组患者分为踝臂指数较低组(n=31,踝臂指数<0.9)和踝臂指数较高组(n=116,踝臂指数≥0.9)。结果:与Ba-PWV较低组比较,Ba-PWV较高组患者年龄较大(P=0.035)、高血压比例较高(P=0.006)、血沉较快(P=0.020)、空腹血糖较高(P=0.002)、血清Irisin水平较低(P=0.007)。将上述变量纳入多因素向后逐步Logistic回归分析模型,结果显示:血清Irisin水平与高Ba-PWV呈负相关(偏相关系数:-0.559,P=0.003,OR=0.572,95%CI:0.394~0.831)。与踝臂指数较低组比较,踝臂指数较高组患者年龄较小(P=0.005)、血清低密度脂蛋白胆固醇较低(P=0.004)、血清总胆固醇较低(P=0.002)、空腹血糖较低(P=0.007)、载脂蛋白B较低(P=0.030)、吸烟人数较多(P=0.045)、血清Irisin水平较高(P=0.014)。将上述变量纳入多因素向后逐步Logistic回归分析模型,结果显示:血清Irisin水平与低踝臂指数呈负相关(偏相关系数-0.734,P=0.035,OR=0.480,95%CI:0.243~0.949)。结论:Irisin与大动脉硬化及外周动脉粥样硬化相关。Objectives：To investigate the association between serum Irisin and brachial ankle pulse wave velocity（Ba-PWV） and ankle brachial index（ABI） in hospitalized adult patients. Methods： A total of 147 patients hospitalized in Fuwai Hospital were enrolled in this study. Patients with acute cerebral haemorrhage and cerebral infarction, acute myocardial infarction, hepatic and renal dysfunction as well as malignant tumor and hematopoietic disorders were excluded. Ba-PWV, brachial systolic pressure and ankle systolic pressure were measured by Complior device. Then ABI was calculated. Serum Irisin level was determined with ELISA kit. The recruited subjects were allocated to 2 groups based on Ba-PWV： high Ba-PWV group（Ba-PWV≥1 400 cm/s, n=93） and low Ba-PWV group（BaPWV1 400 cm/s, n=54）. According to ABI, the participants were also divided into 2 groups： low ABI group（ABI0.9, n=31） and high ABI group（ABI ≥0.9, n=116）.Results： Patients in high Ba-PWV group were older,（P=0.035）, had higher prevalence of hypertension（P=0.006）, higher ESR（P=0.02）, higher fast glucose（P=0.002） and lower serum Irisin level（P=0.007）. Multiple stepwise regression analysis showed that serum Irisin was independently related to Ba-PWV（β=-0.559,P=0.003,OR=0.572（0.394-0.831）. Patients in low ABI group were older（P=0.005）, had higher LDL-C（P=0.004）, higher total cholesterol（P=0.002）, higher fast glucose（P =0.007）, higher apolipoprotein B（P =0.030）, less smoker（P =0.045）, and lower serum Irisin level（P =0.014）. Multiplestepwise regression analysis showed that serum Irisin was independently related to low ABI（β=-0.734, P=0.035, OR=0.480（0.243-0.949）.Conclusions The serum Irisin level is related with arterial stiffness and peripheral arterial atherosclerosis in this patient cohort.

关 键 词：Irisin 动脉硬化 肱-踝动脉脉搏波传导速度 踝臂指数 

分 类 号：R541.4[医药卫生—心血管疾病]