脂联素与冠心病类型和心血管危险因素的关系

The relationship between adiponectin and the type of coronary heart disease and the relationship between adiponectin and cardiovascular risk factors

目的:明确冠心病(CHD)患者脂联素(APN)水平是否下降,确定低APN血症是否是CHD的危险因素及APN水平与CHD类型和心血管危险因素间的关系。方法:117例研究对象分为对照组(CO)、稳定型心绞痛组(SAP)和急性冠状动脉综合征(ACS)组。SAP、ACS组与CO组进行比较了解CHD患者APN水平;比较不同类型患者的APN水平以确定APN水平与CHD类型间的关系;经logistic回归分析确定低APN血症是否是CHD的危险因素;比较合并某一心血管危险因素者与不合并者的APN水平,了解心血管危险因素对APN水平的影响。结果:CO组、SAP组、ACS组3组比较APN呈降低趋势(10.61±3.38,6.98±3.18,4.59±3.69,P<0.05);逐步logistic回归分析结果显示低APN血症(OR值=0.788,p=0.041)、高胆固醇血症(OR值=5.096,p=0.009)为CHD患病的独立危险因素;超重或肥胖、血脂异常、男性、吸烟、合并3个及3个以上危险因素的CHD患者APN水平降低(P<0.05),合并高血压和糖尿病者APN水平无明显下降。结论:CHD患者APN水平下降,ACS患者APN水平较SAP患者进一步下降。低APN血症是CHD的危险因素。肥胖、吸烟、男性、血脂异常可使APN水平下降,且合并心血管危险因素多者APN水平进一步降低。

Objective：To investigate whether concentrations of adiponectin （APN） decrease and constitute a significant coronary risk factor,with focus on the relation between plasma concentrations of APN and risk factor of coronary heart disease （CHD）.Methods：The total of 117 patients were divided into three groups,there were the controlled （CO） group （n=30）,stable angina pectoris （SAP） group （n=26） and acute coronary syndrome （ACS） group （n=61）,comparing the concentration of APN among them. Analysis with multiple logistic regression to observe whether low adiponectin concentration is a risk factor of CHD. Compare the concentration of APN between CHD with and without the coronary risk factor.Results：Concentrations of adiponectin in patients with coronary heart disease were significantly lower than in the control group ,and concentrations of adiponectin in patients with ACS were lower than those in patients with SAP. Low adiponectin concentration correlated with the development of CHD. Additionally,multiple logistic regression analysis showed that low adiponectin concentration was a risk factor of CHD. The concentration of APN without the coronary risk factor was lower. Conclusion：The concentration of adiponectin was lower in CHD,and may be related to the development of CHD. The low concentration of adiponectin was the risk factor of CHD.