冠心病患者血清血管紧张素样蛋白5水平变化及临床意义

Expression Level and Clinical Significance of Serum Angiopoietin-like Protein 5 in Coronary Artery Disease

目的:分析冠心病患者血清血管生成素样蛋白5(ANGPTL5)水平变化及与冠心病糖脂代谢紊乱的相关性。方法:纳入2019-01-2019-12本院就诊的疑似冠心病患者239例,根据冠脉造影结果分为冠心病组(n=156)和非冠心病组(n=83)。酶联免疫吸附试验检测所有患者血清ANGPTL5的表达水平,分析血清ANGPTL5水平与冠心病患者糖脂水平、冠脉病变支数等临床参数的相关性。结果:与非冠心病组相比,冠心病组患者血清ANGPTL5水平明显升高(P<0.01)。随着冠脉病变支数增加,冠心病患者ANGPTL5水平升高,三支病变组水平最高(P<0.05)。合并糖尿病或高脂血症的冠心病患者的血清ANGPTL5水平较未合并糖尿病或高脂血症的冠心病患者明显升高,差异具有统计学意义(P<0.05)。相关性分析显示,冠心病患者血清ANGPTL5水平与空腹血糖(FPG)(r=0.339,P<0.01)、甘油三酯(TG)(r=0.354,P<0.01)、极低密度脂蛋白胆固醇(VLDL-C)(r=0.188,P<0.05)水平均呈正相关。多因素Logistic回归显示ANGPTL5是冠心病的危险因素(OR=1.998,95%CI:1.440-2.773,P<0.01)。校正混杂因素(性别、年龄、空腹血糖和血脂)后血清ANGPTL5水平升高仍是冠心病的危险因素(OR=1.916,95%CI:1.155-3.177,P<0.01)。结论:冠心病患者血清ANGPTL5水平升高,且与冠心病患者糖脂代谢状况和冠脉病变支数有关。

Objective:To investigate changes of the serum level of angiopoietin-like protein 5(ANGPTL5)in coronary artery disease(CAD)patients and explore its relationship with glycometabolism and lipid metabolism.Method:A total of 239 individuals suspected as CAD were enrolled from January 2019 to December 2019.According to the results of coronary angiography,they were classified as CAD group(n=156)and non-CAD group(n=83)respectively.Serum ANGPTL5 levels were detected by enzyme-linked immunosorbent assay.Correlations between serum ANGPTL5 and parameters such as blood lipids,glucose and number of lesion vessels were all evaluated statistically.Results:Serum ANGPTL5 levels in CAD patients were higher than those without CAD(P<0.01).Moreover,serum ANGPTL5 levels were significantly higher in CAD patients with higher lesion vessels,especially the highest in three-vessel group(P<0.05).Similarly,it was higher in patients with diabetes mellitus or hyperlipidemia than those without diabetes mellitus or hyperlipidemia(P<0.05).The ANGPTL5 level was positively correlated with the levels of FPG(r=0.339,P<0.01),triglycerides(r=0.354,P<0.01)and very low density lipoprotein-cholesterol(r=0.188,P<0.05).ANGPTL5 was a risk factor for CAD(OR=1.998,95%CI:1.440-2.773,P<0.01).After the adjustment for confounding factors including sex,age,FPG and blood lipids,patients with higher ANGPTL5 levels still had a higher OR for CAD(OR=1.916,95%CI:1.155-3.177,P<0.01).Conclusion:Serum ANGPTL5 levels were elevated in CAD patients and positively correlated with the disorder of glycometabolism,lipid metabolism and the number of lesion vessels of CAD.