血清ANGPLT3水平与冠心病患者脂代谢和冠状动脉狭窄程度的相关性研究  

Correlation between serum ANGPTL3 level and lipid metabolism and the severity of coronary artery stenosis in patients with coronary artery disease

作　　者：吴星亮 刘畅[1,2,3] 朱秋霞[1,2,3] 张诗琴 方钊 蒋学俊[1,2,3] 易欣 Wu Xingliang;Liu Chang;Zhu Qiuxia;Zhang Shiqin;Fang Zhao;Jiang Xuejun;Yi Xin(Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,China;不详)

机构地区：[1]武汉大学人民医院心内科,湖北省武汉市430060 [2]武汉大学心血管病研究所,湖北省武汉市430060 [3]武汉大学心血管病湖北省重点实验室,湖北省武汉市430060

出　　处：《中国循证心血管医学杂志》2024年第10期1184-1189,1193,共7页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：湖北省自然科学重点研发计划(2022BCA051)。

摘　　要：目的血管生成素样蛋白3(ANGPTL3)在脂质代谢和胰岛素抵抗中发挥重要作用,本文拟观察冠状动脉粥样硬化性心脏病(冠心病)患者血清ANGPTL3的水平,并分析其与冠心病患者脂代谢、冠状动脉狭窄程度的相关性。方法选择武汉大学人民医院心内科2019年1月至12月行冠状动脉造影的患者227例,根据造影结果分为对照组(n=79)和冠心病组(n=148)。收集所有患者的年龄、性别、既往病史、体质指数(BMI)、血糖、血脂等临床和生化资料。采用Gensini评分评估冠状动脉狭窄程度,通过酶联免疫吸附试验(ELISA)检测所有患者血清ANGPTL3的表达水平,并对血清ANGPTL3与血糖血脂指标、Gensini评分等临床参数之间的相关性进行统计学分析。结果对照组患者血清ANGPTL3为25.23(19.38~35.86)ng/ml,冠心病患者的血清ANGPTL3水平为28.05(19.50~40.16)ng/ml,两组间并无显著差异。随着冠状动脉病变血管支数的增加,血清ANGPTL3的水平也逐渐升高,三支病变组中ANGPTL3水平最高(P<0.05)。冠心病患者血清ANGPTL3三分位数分组后,结果显示高分位水平组的高脂血症患病率、总胆固醇(TC)、三酰甘油(TG)、载脂蛋白B(Apo-B)、极低密度脂蛋白(VLDL-C)、Gensini评分最高(P<0.05)。此外,单元及多元线性回归分析均发现血清ANGPTL3水平与冠心病患者Gensini评分密切相关。结论血清ANGPTL3水平升高与冠心病患者的脂质代谢紊乱有关,且与冠心病患者的冠状动脉病变支数、冠状动脉狭窄严重程度相关,提示联合检测血清ANGPLT3对临床评估冠心病患者的脂代谢紊乱、冠状动脉病变程度具有一定的预测价值和临床意义。Objective Angiopoietin-like protein 3(ANGPTL3)plays an important role in lipid metabolism and insulin resistance.In the present study,we aimed to observe circulating ANGPTL3 levels in patients with coronary artery disease(CAD),and analyze its correlation with lipid metabolism and the severity of coronary artery stenosis.Methods A total of 227 individuals,undergoing coronary angiography in the department of cardiology of our hospital from January 2019 to December 2019,were recruited in this study,and all of them were divided into 148 patients with CAD and 79 controls with non-CAD according to the results of coronary angiography.All patients'clinical and biochemical data were collected,including age,gender,medical history,body mass index(BMI),blood glucose,lipid and so on.The Gensini Score was used to evaluate the severity of CAD.Serum ANGPTL3 levels were measured by enzyme-linked immunosorbent assay(ELISA).Correlations between serum ANGPTL3 and clinical parameters such as lipid levels and the Gensini Score were all evaluated statistically.Results The serum ANGPTL3 level in the control group was 25.23(19.38-35.86)ng/ml,and the level in the CAD group was 28.05(19.50-40.16)ng/ml,which shows no significant difference.With an increasing number of coronary artery lesions,the serum ANGPTL3 level also gradually increased,and the 3-vessels group showed a higher ANGPTL3 level(P<0.05).After dividing the serum ANGPTL3 level into tertiles,the high tertile group showed the highest prevalence of hyperlipidemia,TC,TG,Apo-B,and Gensini score(P<0.05).In addition,univariate and multivariate linear regression demonstrated that serum ANGPTL3 levels were strongly associated with the Gensini score.Conclusions The elevated serum ANGPTL3 level is positively related to lipid metabolism in patients with CAD,and associated with the number of coronary artery lesions and severity of coronary artery stenosis,suggesting that detecting serum ANGPTL3 level has certain value and clinical significance for the evaluation of lipid metabolism disorder

关 键 词：冠心病 血管生成素样蛋白3 脂质代谢 病变支数 狭窄程度 

分 类 号：R541.4[医药卫生—心血管疾病]