冠心病患者中血清成纤维细胞生长因子21与胆固醇酯转运蛋白和冠状动脉粥样硬化严重程度之间的相关性研究  

Correlation between FGF21 and CETP and the severity of coronary atherosclerosis in patients with coronary heart disease

作　　者：高宏伟 王远 代佩 冯高洁 高奋[2] GAO Hong-wei;WANG Yuan;DAI Pei;FENG Gao-jie;GAO Fen(Cardiovascular Department,The Second Clinical College of Shanxi Medical University,Taiyuan 030001,China;Cardiovascular Department,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二临床医学院心血管内科,山西省太原市030001 [2]山西医科大学第二医院心血管内科

出　　处：《中国心血管病研究》2020年第11期984-989,共6页Chinese Journal of Cardiovascular Research

基　　金：山西省自然科学基金(201801D121321)。

摘　　要：目的评估血清成纤维细胞生长因子21(FGF21)和胆固醇酯转运蛋白(CETP)与冠心病发生发展之间的关系.方法选取2018年12月至2019年6月在山西医科大学第二临床医院心内科住院治疗且行冠状动脉造影检查的患者214例,分为冠心病组(122例)和对照组(非冠心病)(92例).收集患者一般资料,计算两组患者的Genisini评分,测出血清FGF21和CETP浓度水平,分析FGF21水平与冠心病的发生和冠状动脉病变严重程度之间的关系,以及冠心病患者中FGF21与血清中的CETP水平之间的关系.结果①冠心病组TC、TG、LDL-C水平均明显高于对照组[TC(3.83±1.31)mmol/L比(3.16±1.73)mmol/L;TG(3.64±3.23)mmol/L比(2.22±1.86)mmol/L;LDL-C(3.79±1.05)mmol/L比(2.98±1.11)mmol/L];而HDL-C水平低于对照组[(0.82±0.24)mmol/L比(1.04±0.34)mmol/L],且差异均有统计学意义(P<0.05);②冠心病组血清FGF21水平和CETP水平均高于对照组[FGF21(588.46±147.51)pg/ml比(449.25±145.18)pg/ml];CETP(73.47±15.73)ng/ml比(63.50±11.52)ng/ml,差异有统计学意义(P<0.05);③多因素Logistic回归分析结果显示,FGF21、CETP和LDL-C浓度升高为冠心病的危险因素,HDL-C升高为冠心病的保护因素.FGF21浓度与冠心病的ROC曲线显示,FGF21对冠心病的诊断有预测价值,最佳临界值为592.143 pg/ml;④冠心病组内比较,Pearson相关分析结果显示,HDL-C与FGF21之间存在明显的负相关(r<0,P<0.05);而CETP水平则与FGF21之间均存在明显的正相关(r>0,P<0.05);⑤在冠心病组内比较,根据Genisini评分将患者分为低分组、中分组和高分组,与FGF21浓度行Spearman相关分析,结果显示FGF21与冠状动脉病变严重程度呈正相关.结论FGF21浓度升高可能加重冠心病发生发展,推测FGF21浓度升高可能通过增加CETP从而影响HDL-C的水平.Objective To evaluate the relationship of serum fibroblast growth factor 21(FGF21)and highdensity lipoprotein cholesterol(HDL-C)and coronary heart disease.Methods 214 patients who were hospitalized in the Department of Cardiology of the Second Clinical Hospital of Shanxi Medical University from December 2018 to June 2019 were selected.Among them,there were 122 patients in the coronary heart disease group and 92 patients in non-coronary heart disease group(control group).Collecting general information of patients,the Genisin score of each patient was calculated.And the serum FGF21 and cholesteryl ester transfer protein(CETP)levels were measured by ELISA.SPSS 20.0 was used to analysis the data collected for each of the patients.The relationship between the serum level of FGF21 in the patients and the incidence and the severity of coronary heart disease(estimated by the Genisin scoring system)and the relationship between serum FGF21 and CETP levels of the patients with CHD were analized.Results(l)The levels of TC,TG and LDL-C in patients with coronary heart disease were significantly higher than those in the control group[TC(3.83±1.31)mmol/L vs.(3.16±1.73)mmol/L,TG(3.64±3.23)mmol/L vs.(2.22±1.86)mmol/L,LDL-C(3.79±1.05)mmol/L vs.(2.98±1.11)mmol/L].The level of HDL-C in the coronary heart disease group was lower than that in the control group[(0.82±0.24)mmol/L vs.(1.04±0.34)mmol/L]and the difference was statistically significant(P<0.05).(2)Both the serum FGF21 levels and CETP levels in patients with coronary heart disease group were higher than those in control group[FGF21(588.46±147.51)pg/ml vs.(449.25±145.18)pg/ml,CETP(73.47±15.73)ng/ml vs.(63.50±l 1.52)ng/ml]and the difference was statistically significant(P<0.05).(3)Multivariate Logistic regression analysis showed that elevated FGF21,CETP and LDL-C concentrations were the risk factors for coronary heart disease and elevated HDL-C was a protective factor for coronary heart disease.The ROC curve of FGF21 concentration and coronary heart disease showed th

关 键 词：成纤维细胞生长因子21 冠状动脉疾病 胆固醇脂转运蛋白 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]