脂联素与非糖尿病男性冠心病代谢危险因素的相关性研究

The relationship between adiponectin and coronary heart disease metabofic risk factors in non-diabetic male patients

目的探讨脂联素和各种代谢异常在非糖尿病男性冠心病中的相互作用。方法研究对象为复旦大学附属中山医院心内科首次行冠状动脉造影患者,对非糖尿病男性进行亚组分析,冠心病组127例,对照组为年龄匹配的造影阴性者88例。测量形体参数,检验生化指标、血清脂联素。脂联素和各种代谢危险因素的相关性用偏相关分析,脂联素、代谢异常与冠心病的关系采用 Logistic多元逐步回归分析。结果研究对象年龄59岁±9岁,非糖尿病男性冠心病组脂联素浓度低于对照组[7.9(5.7～11.6)mg/L 比10.0(7.0～13.5)mg/L,P=0.014]。偏相关分析显示控制年龄后脂联素浓度与甘油三酯(TG)、总胆固醇(Tc)和负荷后2 h 血糖(PPG2 h)、体重指数(BMI)及代谢异常积分呈负相关(r 分别为-0.250、-0.169、-0.167、-0.246和-0.198,均 P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈正相关(r=0.201,P=0.001)。控制年龄和 BMI 后,脂联素与 TC、TG 仍保持负相关(r 分别为-0.170和-0.193,均 P<0.05)。Logistic 多元逐步回归分析显示 TG 与脂联素浓度与冠心病存在独立相关(OR 分别为2.277和0.533)。结论脂联素受代谢异常积聚的影响,高脂联素是冠心病的保护因素。

Objective To investigate the correlation between adiponectin and metabolic risk factors of coronary heart disease in non-diabetic male patients. Methods 215 non-diabetic males aged （59±9 ） underwent coronary angiography （CAG） and then divided into coronary heart disease group （ n = 127 ） and control group （ n = 88 ） according to the CAG results. The anthroposomatologic parameters were measured. Blood sugar and lipids were examined. Adiponetcin levels was detected with radioimmunoassay. Results The mean adiponectin level of the coronary heart disease group was 7.9 （5.7-11.6 ） mg/L, significantly lower than that of the control group [ 10.0（7.0-13.5） mg/L,P =0. 014]. The adiponectin level of females was lower than those of the males, no matter whether with coronary heart disease. Partial correlation analysis showed that the adiponectin level was negatively correlated with the serum triglyceride, total cholesterol, post-challenge glucose level and body mass index（r = - 0. 250, - 0. 169, - 0. 167, - 0. 246, and - 0. 198, all P 〈 0.05 ） , and positively correlated with HDL-C （ r = 0. 201, P = 0.001 ） after the age factor was controlled. Logistic multivariable stepwise regression analysis demonstrated levels of triglyceride and adiponectin independently associated with the presence of coronary heart disease （ OR = 2. 277 and 0. 533 respectively）. Conclusion Adiponectin is influenced by metabolic disorders. Higher adiponectin level is a protective factor of coronary heart disease.