人视黄醇结合蛋白4水平升高与冠心病及其预后相关

Elevated plasma levels of retinol-binding protein-4 are associated coronary artery disease and one-year prognosis

目的:研究人视黄醇结合蛋白4(RBP4)水平与冠心病及1年预后关系。方法:选择因疑诊冠心病而行冠状动脉造影的140例非糖尿病患者,其中确诊冠心病患者94例,非冠心病患者46例(作为对照)。采用ELISA试剂盒(德国IBL公司)检测140例患者血浆RBP4水平。冠心病患者出院后完成1年随访,记录主要不良心脏事件(MACEs),即再发心绞痛、再发心肌梗死、心力衰竭恶化和心源性死亡。多变量回归分析RBP4与1年随访MACEs关系。结果:与对照组比,冠心病组高血压、吸烟比例、年龄和RBP4水平[(51.69±34.96)μg.ml-1比(37.84±15.94)μg.ml-1]均显著升高或增长(均P<0.05)。冠心病组发生MACEs共8例,事件组平均RBP4水平显著高于无事件组[(76.12±42.89)μg.ml-1比(46.24±17.66)μg.ml-1,P<0.01],事件组ρ(RBP4)≥70μg.ml-1的比例显著高于无事件组(37.50%比9.30%,P=0.018)。多变量回归分析证实,RBP4水平与1年随访MACEs独立相关联(OR:1.091,95%CI:1.015～1.172,P=0.018)。结论:RBP4水平升高与冠心病及1年预后相关,基线RBP4水平升高者1年主要不良心脏事件风险增加。

Objective： To examine whether plasma levels of retinol-binding protein-4 （RBP4） are associated with coronary artery disease （CAD） and one-year prognosis. Methods： RBP4 levels were determined by ELISA kit （ IBL. Germany） in 140 patients without type 2 diabetes undergoing coronary angiography for the concern of CAD. Patients were divided into controls （normal coronary arteries. n = 46） and CAD （ ≥ 50% diameter stenosis, n = 94）. CAD patients were followed up for average 12 months. Major adverse cardiac events （MACEs） including recurrent anginal, recurrent infarction, deteriorated heart failure and cardiac death were analyzed. Multivariate analysis was done to determine the association between RBP4 and composite MACEs during one-year follow up.Results： Compared to the controls, patients with CAD were older, had higher prevalence of hypertension and smokers （all P 〈0. 05）. RBP4 levels were elevated in patients with CAD [ （51.69 ±34. 96） μg·ml^-1 vs （37. 84±15.94） μg·ml^-1 and smokers [（59.44±45.12） μg·ml^-1 vs （41.88 ±19.90） μg·ml^-1] （allP〈0.05）. Meanwhile, patients suffering from MACEs （ n = 8 ） had higher levels of RBP4 than those without [ （ 76. 12 ± 42. 89） μg·ml^-1 vs （46. 24 ± 17. 66） μg·ml^-1 , P 〈0. 01 ] ; these patients suffering from MACEs had higher ratio of RBP4 levels ≥ 70 μg·ml^-1 than those without （ 37.50% vs 9.30%, P =0. 018 ）. Multivariate analysis demonstrated that RBP4 was an independent predictor of composite MACEs during one-year follow up （ OR ： 1. 091, 95% CI： 1. 015-1. 172, P =0. 018）. Conclusion： RBP-4 levels are associated with CAD and one-year prognosis. Patients with higher RBP-4 levels are at higher risk of MACEs.