血清成纤维细胞生长因子21、脂联素与冠状动脉性心脏病的相关性

The relationship between serum fibroblast growth factor 21,adiponectin and coronary heart disease

  • 摘要: 目的探讨血清成纤维细胞生长因子21(FGF21)、脂联素与冠状动脉性心脏病(冠心病)的相关性。方法入选2013年6月到2014年6月于福建省立医院接受冠状动脉造影检查的375例住院患者,年龄(63.3±9.8)岁,根据造影结果分为冠心病组(n=232)和非冠心病组(n=143)。酶联免疫吸附试验用于测定各组血清中FGF21和脂联素水平。应用多因素Logistic回归分析冠心病与FGF21、脂联素的相关性。结果冠心病组男性、吸烟和糖尿病史比例、年龄、腰臀比、空腹血糖、糖化血红蛋白(HbA1c)水平高于非冠心病组(均P<0.05),FGF21(357.5±14.0)比(419.2±17.0)ng/L、脂联素(6.5±0.5)比(8.1±0.8)mg/L低于非冠心病组(均P<0.05)。偏相关分析显示,FGF21与冠状动脉病变支数(r=-0.104,P<0.05)和Gensini评分(r=-0.128,P<0.05)呈负相关;Spearman相关分析显示,FGF21与脂联素呈正相关(rs=0.200,P<0.05)。在校正年龄、性别、吸烟、HbA1c、高密度脂蛋白胆固醇(HDL-C)以及稳态模型评估的胰岛素抵抗指数后,多因素Logistic回归分析结果显示,HDL-C(OR=0.368,P<0.05)和FGF21(OR=0.376,P<0.05)是冠心病的保护因素,年龄(OR=1.032,P<0.05)、HbA1c(OR=2.038,P<0.01)以及吸烟(OR=1.999,P<0.05)是冠心病的危险因素。结论 FGF21是冠心病的保护因素之一,其与脂联素呈正相关,与冠状动脉病变支数和Gensini评分呈负相关。

     

    Abstract: Objective To explore the relationships between serum fibroblast growth factor 21(FGF21),adiponectin and coronary heart disease(CHD). Methods A total of 375 patients were recruited between June 2013 and June2014,including 232 patients with CHD(CHD group)and 143 patients without CHD(non-CHD group). The mean age of the participants was(63.3±9.8)years old. The levels of serum FGF21 and adiponectin were measured by enzyme-linked immunosorbent assay. Multivariate Logistic regression was used to analyze the relationships between serum FGF21,adiponectin and CHD. Results Compared with non-CHD group,proportion of male,smoking and diabetes mellitus,age,waist to hip ratio,fasting glucose,glycosylated hemoglobin(HbA1c)levels were higher,and FGF21(357.5±14.0)vs(419.2±17.0)ng/L,adiponectin(6.5±0.5)vs(8.1±0.8)mg/Lwere lower in CHD group(all P<0.05). Partial correlation analysis showed that serum FGF21 level was negatively correlated with the Gensini score(r=-0.128,P<0.05)and the lesion number in the coronary artery(r=-0.104,P<0.05). However,there was a positive association between FGF21 and adiponectin in Spearman correlation analysis(rs=0.200,P<0.05). After adjustment for sex,age,smoking,HbA1 c,high-density lipoprotein cholesterol(HDL-C)and homeostasis model assessment of insulin resistance,multivariate Logistic regression analysis revealed that HDL-C(OR=0.368,P<0.05)and FGF21(OR=0.376,P<0.05)were the protective factors for CHD; age(OR=1.032,P<0.05),HbA1c(OR=2.038,P<0.01)and smoking(OR=1.999,P<0.05)were the risk factors for CHD. Conclusion Serum FGF21 is one of the protective factors for CHD,and it is positively correlated with adiponectin,while negatively correlated with the Gensini scores and the number of coronary artery lesions.

     

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