糖尿病患者血清游离脂肪酸水平与早发急性心肌梗死的相关性分析  

Analysis of correlation between serum free fatty acid and premature acute myocardial infarction in patients with diabetes mellitus

作　　者：管强麟 乔家明 周玉杰[1] Guan Qianglin;Qiao Jiaming;Zhou Yujie(The 12th Ward,Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vessel Diseases,Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease,Clinical Center for Coronary Heart Disease,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内十二病房,北京市心肺血管疾病研究所,冠心病精准治疗北京市重点实验室,首都医科大学冠心病临床诊疗与研究中心,北京100029

出　　处：《中国医药》2022年第8期1145-1149,共5页China Medicine

基　　金：国家重点研发计划(2017YFC0908800);北京市医院管理局“使命”人才计划(SML20180601)。

摘　　要：目的探讨糖尿病患者血清游离脂肪酸(FFA)水平与早发急性心肌梗死(AMI)的相关性。方法入组2019年1—12月于首都医科大学附属北京安贞医院就诊并最终诊断为早发AMI的糖尿病患者123例(心肌梗死组),并选取同年龄段未发生AMI的糖尿病患者145例(非心肌梗死组)作为对照。回顾性分析2组的临床资料、实验室检查结果。根据血清FFA水平的四分位数将所有患者分为Q1~Q4组,分析4组间的参数差异。采用多因素Logistic回归方法分析FFA与早发AMI的相关性。结果 心肌梗死组吸烟史比例、高敏C反应蛋白(hs-CRP)和FFA水平均高于非心肌梗死组[56.1%(69/123)比33.8%(49/145)、4.6(2.5,7.3)mg/L比1.3(0.6,4.0)mg/L、0.68(0.59,0.82)mmol/L比0.56(0.45,0.68)mmol/L],差异均有统计学意义(均P<0.001)。对Q1组(0.14~0.48 mmol/L,71例)、Q2组(0.49~0.62 mmol/L,68例)、Q3组(0.63~0.75 mmol/L,70例)和Q4组(0.76~2.11 mmol/L,59例)患者吸烟史者比例、hs-CRP水平和早发AMI发生率进行比较,结果显示4组患者吸烟史比例及hs-CRP水平差异无统计学意义(均P>0.05),而Q4组早发AMI发生率明显高于其他3组(均P<0.05)。多因素Logistic回归分析结果显示,吸烟、hs-CRP和总体患者FFA分组Q4组FFA水平与早发AMI发生独立相关(均P<0.05)。结论糖尿病患者的FFA水平与早发AMI密切相关,此类患者的FFA水平升高可侧面反映早发AMI的风险增加。Objective To investigate the correlation between serum free fatty acids(FFA) and premature acute myocardial infarction(AMI) in patients with diabetes mellitus. Methods From January to December 2019, 123 patients with premature AMI and diabetes mellitus [myocardial infarction(MI) group] were enrolled in the Beijing Anzhen Hospital, Capital Medical University, and 145 patients without AMI(non MI group) were selected as controls. The clinical data and laboratory results of the two groups were analyzed retrospectively. According to the quartile of serum FFA level, the patients were divided into Q1-Q4 groups. The parameter differences among the four groups were analyzed. Multivariate Logistic regression was used to analyze the correlation between FFA and premature AMI. Results The proportion of smoking history, the levels of high-sensitivity C-reaction protein(hs-CRP) and FFA in MI group were higher than those in non MI group[56.1%(69/123) vs 33.8%(49/145), 4.6(2.5,7.3)mg/L vs 1.3(0.6,4.0)mg/L, 0.68(0.59,0.82)mmol/L vs 0.56(0.45,0.68)mmol/L](all P<0.001). Q1 group(0.14-0.48 mmol/L, 71 cases), Q2 group(0.49-0.62 mmol/L, 68 cases), Q3 group(0.63-0.75 mmol/L, 70 cases) and Q4 group(0.76-2.11 mmol/L, 59 cases) had no significant difference in smoking proportion and hs-CRP level(all P>0.05), while the proportion of premature AMI in Q4 group was significantly higher than that in the other three groups(all P<0.05). Multivariate Logistic regression analysis showed that smoking, hs-CRP and the level of FFA in Q4 group were independently correlated with the occurrence of premature AMI(all P<0.05). Conclusions The level of FFA in patients with diabetes mellitus is closely correlated to the occurrence of premature AMI, and the increased level of FFA in such patients can reflect the increased risk of premature AMI.

关 键 词：糖尿病 游离脂肪酸 冠心病(冠状动脉粥样硬化性心脏病) 早发急性心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]