PON1浓度在冠心病合并肥胖患者中的变化及其与代谢状态、炎性反应的相关性  

Changes of Paraoxonase 1 Concentration in Patients with Coronary Heart Disease and Obesity and its Correlation with Metabolic Status and Inflammation

作　　者：张若尘 马爱群[1] 卢群 ZHANG Ruo-chen;MA Ai-qun;LU Qun(Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education,Key Laboratory of Molecular Cardiology of Shaanxi Province,Institute of Cardiovascular Medicine of Xi'an Jiaotong University,Department of Cardiovascular Medicine,The First Affiliated Hospital of Xi'an Jiaotong University Medical College,Xi'an Jiaotong University Medical College,Xi'an 710061,China)

机构地区：[1]西安交通大学医学院,西安交通大学医学院第一附属医院心内科,西安交通大学心血管研究所,陕西省分子心脏病学重点实验室环境与疾病相关基因教育部重点实验室,西安市710061

出　　处：《中国分子心脏病学杂志》2020年第4期3459-3463,共5页Molecular Cardiology of China

基　　金：国家重点研发计划(2017YFC1308302)。

摘　　要：目的探讨血清对氧磷脂酶1(PON1)浓度在冠心病合并肥胖患者中的变化及PON1浓度与冠心病合并肥胖患者代谢状态、炎性反应水平的相关性。方法选取2008年8月至2009年8月在西安交通大学第一附属医院心内科住院治疗的冠心病患者413例,以及同期经冠脉造影证实的非冠心病患者270例(对照组)。收集患者性别、年龄、吸烟史、总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、空腹血糖(FPG)、白细胞(WBC)、尿酸(UA)等资料,依据体重指数(BMI)将冠心病组分为正常体型、超重、肥胖三个亚组。用酶联免疫吸附法检测PON1水平。结果相比对照组,冠心病组男性患者、吸烟人数、代谢综合征患者比例、BMI、TG、LDL-C、FPG、WBC、UA等指标升高(P<0.05);HDL-C、Lg(PON1)降低(P<0.001)。在不同体型的冠心病各组中,随着BMI增加,代谢综合征患者比例、收缩压(SBP)、舒张压(DBP)、TG、FPG呈上升的趋势;Lg(PON1)呈降低态势,其中肥胖冠心病组Lg(PON1)水平显著低于超重冠心病组和正常体型冠心病组,且差异均具有统计学意义。Lg(PON1)与代谢指标HDL-C成正相关,与SBP、DBP、FPG、TG、BMI、代谢综合征呈负相关;与炎性反应指标WBC、UA、Lg(HS-CRP)(经对数转换后的超敏C反应蛋白)呈负相关。结论PON1浓度在冠心病合并肥胖患者中降低,PON1浓度可以反映冠心病合并肥胖患者的代谢状态及炎性反应水平,PON1浓度越低则患者代谢紊乱越严重、炎性反应越强。Objective To investigate the change of PON1 concentration in patients with coronary heart disease and obesity and the correlation of PON1 concentration with metabolic status and inflammation in patients with coronary heart disease and obesity.Methods From August 2008 to August 2009,413 patients with coronary heart disease who were hospitalized in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xi’an Jiaotong University Medical College and 270 patients with non-coronary heart disease confirmed by coronary angiography during the same period(control group)were selected.Patient gender,age,smoking history,total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),fasting blood glucose(FPG),white blood cell(WBC),uric acid(UA)were collected.Patients with coronary heart disease were divided into three subgroups of normal body shape,overweight,and obesity according to the level of body mass index(BMI).Enzyme-linked immune sorbent assay was used to detect the level of PON1.Results Compared with the control group,male patients,the number of smokers,the proportion of patients with metabolic syndrome,the BMI,TG,LDL-C,FPG,WBC,and UA increased in the coronary heart disease group(P<0.05);HDL-C,Lg(PON1)decreased(P<0.001).In each group of coronary heart disease of different body types,with the increase of BMI,the proportion of patients with metabolic syndrome,systolic blood pressure(SBP),diastolic blood pressure(DBP),TG,FPG showed an upward trend;Lg(PON1)showed a downward trend,of which Lg(PON1)in obese coronary heart disease group was significantly lower than that in overweight subgroup and normal body weight subgroup.Lg(PON1)was positively correlated with metabolic markers HDL-C,and negatively correlated with SBP,DBP,FPG,TG,BMI,and metabolic syndrome,as well as inflammation markers WBC,UA,Lg(HS-CRP)(the logarithmic conversion of hypersensitive C-reactive protein)Conclusion The concentration of PON1 decreases in patients with coronary heart disease and obe

关 键 词：冠心病 代谢状态 炎性反应 肥胖 对氧磷脂酶1 

分 类 号：R541.4[医药卫生—心血管疾病] R589.2[医药卫生—内科学]