高胆固醇血症患者中不同分子量脂联素的分布及其与冠心病的相关性

Distribution of adiponectin multimers and their relationship with cardiovascular risk factors in patients with hypercholesterolemia

目的:探讨血循环中不同分子量多聚体形式的脂联素(APN)在高胆固醇血症患者中的分布及其与冠心病的相关性。方法:研究对象包括148例男性高胆固醇血症患者,按是否并发冠心病又分为单纯高胆固醇组(n=68)和并发冠心病组(n=80),另选年龄及体质量指数(BMI)与高胆固醇组相匹配的健康查体者(健康对照组,n=84)。排除糖尿病、高血压病、肾脏疾病及重度吸烟人群。结果:与健康对照组相比,高分子量APN和中分子量APN在单纯高胆固醇组显著增加[高分子量APN亚组:(4.98±0.87)mg/L vs.(2.51±0.33)mg/L,P<0.01;中分子量APN亚组:(2.20±0.36)mg/L vs.(1.01±0.15)mg/L,P<0.01],而在并发冠心病组患者中显著降低,且与健康对照组无显著差异。与其它APN多聚体相比,高分子量APN与冠心病相关心血管危险因素———总胆固醇(TC,r=0.345,P<0.05)、高密度脂蛋白胆固醇(HDL-C,r=0.325,P<0.05)及尿酸(UA,r=-0.472,P<0.01)水平密切相关。Logistic回归分析显示高分子量APN是高胆固醇血症患者发生冠心病的独立危险因素(OR,8.43;P<0.05)。结论:高胆固醇血症患者中高分子量APN水平的降低与并发冠心病有相关性。

AIM ： To determine the circulatory distribution of hormone adiponectin （APN） multimers and their relationships with cardiovascular disease （CVD）-related biochemical indicators in patients with hypereholesterolemia （HC）. METHODS： A total of 148 age- and body mass index （BMI）-matched male patients with HC （80 with CVD and 68 without CVD） and 84 healthy male controls were enrolled. Diabetes mellitus, hypertension, nephropathy and smoking habit constituted exclusion criteria. RESULTS： Both high molecular weight （HMW） and medium molecular weight （MMW） forms of APN significantly increased in HC without CVD （HMW： 4.98±0.87 vs. 2.51 ±0.33 in controls, P 〈0.01; MMW： 2. 20 ±0. 36 vs. 1.01 ±0. 15 in control, P 〈0. 01 ） and were comparable to those in patients with HC- related CVD （HCVD）. In comparison to other APN oligomers, HMW was most closely associated with the HCVD-related biochemical factors ： total cholesterol （ r = 0. 345, P 〈 0. 05 ） , high-density lipoprotein cholesterol （HDLc, r = 0. 325, P 〈 0. 05） and uric acid （ UA, r = - 0. 472, P 〈 0. 01 ）. Additional analysis via binary logistic regression suggested HMW APN was an independent predictor of risk for HCVD （OR, 8.434; P =0. 018）. CONCLUSION： Reduced HMW isoform concentrations may predict the possibility of cardiovascular complications in HC patients.