代谢紊乱患者血清脂联素水平与冠状动脉病变程度的关系

Correlation between adiponectin levels and severity of coronary artery atheroselerosis in patients with metabolic disorder

目的探讨代谢紊乱患者血清脂联素水平及其与冠状动脉病变程度的关系。方法100例患者分为代谢综合征组和对照组，分别行冠状动脉造影检查及血清脂联素水平的检测，对比各组血清脂联素水平和冠状动脉病变程度的差异。结果（1）代谢综合征组空腹血糖（FPG）、三酰甘油（TG）、稳态模型评估法计算的胰岛素抵抗指数（HOMA-IRI）、体重指数、腰围、收缩压、舒张压和Gensini评分均高于对照组，血清脂联素和高密度脂蛋白-胆固醇（HDL-C）水平低于对照组（P〈0．01）。（2）随着代谢紊乱数目的增加，血清脂联素水平逐渐下降，Gensini评分逐渐升高（P〈0．05或〈0．01）。1项及以下代谢紊乱者与2项及以上代谢紊乱者之间的冠心病患者比例比较，差异有统计学意义（P〈0．01）。（3）脂联素与HDL-C呈正相关，与Gensini评分、TG及代谢紊乱数目呈负相关。结论代谢紊乱患者随着代谢紊乱数目的增加，血清脂联素水平降低，冠状动脉粥样硬化程度加重。

Objective To investigate the correlation between adiponectin levels and severity of coronary artery atherosclerosis in patients with metabolic disorder. Methods Coronary angiographies were done and serum adiponectin concentrations were measured in 100 patients who were divided into two groups （metabolic syndrome group and control group）according to the number of metabolic disorders, and the serum levels of adiponeetin and severity of coronary artery atherosclerosis were compared. Results （ 1 ）Compared with control group, metabolic syndrome group had higher levels of fasting plasma glucose, triglyceride, homeostasis model assessment-insulin resistance ndex, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure and C, ensini score. But lower levels of adiponectin and high-density lipoprotein cholesterol （P 〈 0.01 ）. （ 2 ）With the number of metabolic disorders increased, the levels of adiponectin decreased gradually,and Gensini scores of coronary artery atherosclerosis increased gradually （P 〈 0.05 or 〈 0.01 ）. There were much more patients suffered from coronary heart disease in the group which had two or more metabolic disorders than those which had one or none metabolic disorder （P 〈 0.01 ）. （3）The level of adiponeefin was positively correlated with the high-density lipoprotein cholesterol, but negatively correlated with the C, ensini score of coronary artery atherosclerosis, triglyceride and the numbers of metabolic disorders. Conclusion Patients with metabolic disorder have lower adiponectin levels and severer course of coronary artery atheroselerosis.