低脂联素血症是冠状动脉粥样硬化严重程度的重要标志

Hypoadiponectinemia: an important marker indicating the severity of coronary artery atherosclerosis

目的探讨人血浆脂联素水平与冠状动脉粥样硬化病变程度的关系.方法根据冠状动脉造影结果和临床表现,将172例临床可疑的冠心病患者进行分组,用放射免疫法检测血浆脂联素水平,同时监测患者血脂、血压、血糖及体重指数(BMI)等相关指标.结果 (1)动脉粥样硬化病变患者血浆脂联素水平[10.7 mg/L(1.5～40.5 mg/L)]明显低于阴性对照[14.3 mg/L(2.4～39.8)mg/L,P＜0.01].脂联素水平随动脉粥样硬化程度的加重呈进行性下降.(2)血浆脂联素水平与冠状动脉的狭窄程度、BMI及甘油三酯呈负相关,与胰岛素敏感性指数及高密度脂蛋白胆固醇呈正相关(P＜0.05).结论血浆脂联素水平随动脉粥样硬化的发展呈进行性下降,低脂联素血症是动脉粥样硬化发生发展的独立危险因素.

Corresponding author: ZOU Da jin Abstract Objective To explore the association between the levels of plasma adiponectin and the severity of coronary artery atherosclerosis. Methods In this study, 172 cases with suspected coronary heart disease were divided into groups according to coronary angiography and clinical manifestration. Fasting plasma adiponectin was assayed by radioimmunoassay, and related parameters such as blood pressure, body mass index (BMI), fasting blood glucose, lipids, and insulin were measured. Results (1) Plasma adiponectin concentration in patients with atherosclerosis 〔10.7 mg/L (1.5 40.50 mg/L)〕was decreased as compared with that in the negative controls 〔14.3 mg/L (2.4 39.8 mg/L), P< 0.01〕. The level of adiponectin fell in parallel with the severity of coronary artery atherosclerosis in these patients. (2) Plasma adiponectin level was negatively correlated with the extent of coronary artery stenosis, BMI and triglyceride level, while positively correlated with the insulin sensitive index and high density lipoprotein cholesterol (P<0.05). Conclusion Plasma adiponectin concentrations decrease progressively with the advancing coronary atherosclerosis. Hypoadiponectinemia is the independent risk factor of atherogensis.