血清adipsin与冠心病合并糖尿病患者冠状动脉易损斑块的相关性  

Correlation between serum adipsin and coronary artery vulnerable plaque in patients with coronary heart disease complicating diabetes

作　　者：张娜[1,2] 赵美丽 ZHANG Na;ZHAO Meili(Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014040,China;Department of Cardiovascular Medicine,Ulanqab Municipal Central Hospital,Ulanqab,Inner Mongolia 012000,China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014040 [2]乌兰察布市中心医院心血管内科,内蒙古乌兰察布012000

出　　处：《重庆医学》2025年第1期158-162,167,共6页Chongqing Medical Journal

摘　　要：目的研究血清降脂蛋白(adipsin)与易损斑块之间的相关性。方法选取2023年1月至2024年1月因胸痛在乌兰察布市中心医院心血管内科住院的80例冠心病合并糖尿病患者作为研究对象,行冠状动脉造影及光学相干断层(OCT)检查,测定血清降脂蛋白水平,采用二元logistic回归分析血清降脂蛋白与薄纤维帽粥样硬化斑块(TCFA)的关系。采用受试者工作特征(ROC)曲线分析降脂蛋白预测TCFA的诊断效能。结果TCFA组肌酐、低密度脂蛋白-胆固醇(LDL-C)、血清降脂蛋白水平高于非TCFA组,差异有统计学意义(P<0.05);高降脂蛋白组中TCFA及急性心肌梗死比例高于低降脂蛋白组,差异有统计学意义(P<0.05);二元logistic回归分析结果显示,肌酐、LDL-C、血清降脂蛋白均为TCFA的独立预测因素(P<0.05);ROC曲线显示,血清降脂蛋白预测TCFA的AUC为0.702(95%CI:0.589~0.815,P=0.002),截断值为2.845 ng/mL,灵敏度为0.897,特异度为0.585。结论血清降脂蛋白作为TCFA的独立预测因素,与冠心病合并糖尿病患者易损斑块的发生与发展有密切关系。Objective To study the correlation between serum adipsin and vulnerable plaques.Methods A total of 80 patients with coronary heart disease complicating diabetes mellitus due to chest pain hospitalized in the cardiovascular medicine department of Ulanqab Municipal Central Hospital from January 2023 to January 2024 were selected as the study subjects and conducted the coronary angiography and optical coherence tomography(OCT).The serum adipsin level was detected.The relationship between serum adipsin and thin fibrous cap atherosclerotic plaque(TCFA)was analyzed by binary logistic regression.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of adipsin in predicting TCFA.Results The levels of creatinine,low-density lipoprotein-cholesterol(LDL-C)and serum adipsin in the TCFA group were significantly higher than those in the non-TCFA group,and the difference was statistically significant(P<0.05);the proportions of TCFA and acute myocardial infarction in the high adipsin group were higher than those in the low adipsin group,and the difference was statistically significant(P<0.05).The binary logistic regression analysis results showed that creatinine,LDL-C and serum adipsin all were the independent predictive factors of TCFA(P<0.05).The ROC curve showed that AUC of serum adipsin in predicting TCFA was 0.702(95%CI:0.589-0.815,P=0.002),the cut-off value was 2.845 ng/mL,the sensitivity was 0.897 and the specificity was 0.585.Conclusion As an independent predictive factor of TCFA,serum adipsin is closely related to the occurrence and development of vulnerable plaques in the patients with coronary heart disease complicating diabetes.

关 键 词：降脂素 冠心病 糖尿病 易损斑块 

分 类 号：R587[医药卫生—内分泌]