血清脂肪细胞型脂肪酸结合蛋白与冠心病及其危险因素的相关性

Association of Serum Adipocyte Fatty Acid Binding Proteins with Coronary Artery Disease and Its Risk Factors

目的研究血清脂肪细胞型脂肪酸结合蛋白水平与冠心病及其危险因素之间的相关性,探讨其对冠心病及血管病变程度的预测价值。方法经冠状动脉造影选取340名患者,用病变血管支数和Gensini积分表示冠状动脉病变程度,酶联免疫吸附法测定血清脂肪细胞型脂肪酸结合蛋白水平。结果血清脂肪细胞型脂肪酸结合蛋白水平在三支病变组[18.6(13.8～24.0)μg/L]高于非冠心病组[16.4(13.5～20.4)μg/L,P<0.05]及单支病变组[17.5(13.5～20.3)μg/L,P<0.05];女性[20.0(16.9～23.9)μg/L]明显高于男性[15.4(12.5～20.3)μg/L,P=0.000];总体冠心病组血清脂肪细胞型脂肪酸结合蛋白水平[18.3(13.2～22.8)μg/L]较非冠心病组[16.4(13.5～20.4)μg/L]升高,但差异无统计学意义(P=0.088)。女性冠心病组血清脂肪细胞型脂肪酸结合蛋白[22.8(18.6～25.7)μg/L]明显高于非冠心病组[18.1(15.6～21.8)μg/L,P<0.01]。血清脂肪细胞型脂肪酸结合蛋白与Gensini积分呈正相关(男性r=0.105,P<0.05;女性r=0.405,P<0.01),多元回归分析发现血清脂肪细胞型脂肪酸结合蛋白与女性Gensini积分有独立相关性(P=0.018)。血清脂肪细胞型脂肪酸结合蛋白与甘油三酯(r=0.187,P<0.01)、空腹血糖(r=0.115,P<0.01)、高敏C反应蛋白(r=0.135,P<0.05)等心血管危险因素呈明显正相关,与高密度脂蛋白胆固醇(r=-0.168,P<0.01)及载脂蛋白A1(r=-0.126,P<0.05)呈明显负相关。结论血清脂肪细胞型脂肪酸结合蛋白可能成为预测人类冠心病及血管病变程度的有用指标,它是女性冠心病的独立危险因素,可能对糖代谢及脂代谢有一定影响。

Aim To measure the serum adipocyte fatty acid binding protein （A-FABP） levels in patients with and without coronary artery disease （CAD）,trying to investigate the relationship between A-FABP and severity of coronary stenosis,risk factors of CAD.Methods The study cohort included 340 subjects who underwent coronary angiography.The severity of coronary artery stenosis was assessed by the numbers of involved coronary artery branches and the sum of the Gensini scores.Serum A-FABP levels were determined by enzyme-linked immuneosorbent assays.Results The levels of serum A-FABP were significantly higher in patients with three vessel lesions （18.6（13.8～24.0）μg/L） than those with single vessel lesion （17.5（13.5～20.3） μg/L,P〈0.05） and those with non-lesions （16.4（13.5～20.4） μg/L,P〈0.05）.CAD patients tend to have higher A-FABP levels （18.3（13.2～22.8） μg/L） than non-CAD subjects （16.4（13.5～20.4） μg/L）,but the difference did not reach statistical significance （P=0.088）.Women had higher serum A-FABP level than men （20.0（16.9～23.9）vs 15.4（12.5～20.3）μg/L,P〈0.05） and the difference in A-FABP were statistically significant between CAD patients and controls in females（22.8（18.6～25.7）μg/L vs 18.1（15.6～21.8） μg/L）.Serum A-FABP levels were positively correlated with Gensini scores in both men （r=0.105,P〈0.05） and women （r=0.405,P〈0.01）.Multiple linear regression analysis showed that serum A-FABP level was independently associated with Gensini scores in women （P=0.018）,but not in man.A-FABP positively associated with triglyceride （TG）（r=0.187,P〈0.01）,fasting blood-glucose （FBG）（r=0.115,P〈0.01） and high sensitivity C-reaction protein （hs-CRP）（r=0.135,P〈0.05）,and inversely with high density lipoprotein cholesterol （HDLC） （r=-0.168,P〈0.01） and apolipoprotein（ApoA1）（r=-0.126,P〈0.05）.Conclusion Serum A-FABP levels could reflect the extent of coronary artery atherosclerosis,and it is associated with CAD more closely in females than in males.A-FABP might participate in glucose and lipid metabolic disorders.