视黄醇结合蛋白4与冠状动脉病变的相关性

Correlation between retinol binding protein 4 and coronary artery disease

目的探讨新型脂肪因子血清视黄醇结合蛋白（RBP）4与血脂和冠状动脉病变的关系。方法入选181例行冠状动脉：造影检查的心内科住院患者，年龄39～86岁，按血清RBP4水平的四分位数分为4组：RBP4〈811gg／L（RBP4〈811）组、RBP4为811～〈1092／xg／L（RBP4811～〈1092）组、RBP4为1092～〈1356μg／L（RBP41092-G1356）组、RBP4≥1356／xg／L（RBP4≥1356）组。比较4组间临床特征的差异，探讨冠状动脉粥样硬化指数（CAI）的影响因素。结果RBP4≥1356组的血清三酰甘油（TG）、血清尿素氮、血清肌酐、尿酸、餐后2h12肽水平均显著高于RBP4〈811组（P值均G0．05），而估测的肾小球滤过率（eGFR）则显著低于RBP4〈811组和RBP41092--G1356组（P值均G0．05）。校正年龄和性别后的偏相关分析显示，RBP4（r=0．204）、空腹血糖（r=0．250）、糖化血红蛋白（r=0．242）与cAI呈正相关（P值均G0．05）。多元逐步回归分析显示，RBP4（β=0．201）是CAI的独立影响因素（PG0．05），年龄（pβ=-0．409）、RBP4（β=-O．259）是eGFR的独立影响因素（P值均G0．01）。结论血清RBP4水平较高患者的TG水平明显升高，TG是RBP4的独立相关因素。血清RBP4水平与冠状动脉病变程度和肾小球滤过功能独立相关。

Objective To investigate the relationship between retinol binding protein 4 （RBP4） and dyslipidemia as well as coronary artery disease. Methods A total of 181 subjects （aged 39-86 years） from the Department of Cardiology were enrolled in this study. All subjects underwent complete physical examination and coronary angiography. They were divided into 4 groups according to RBP4 quartiles： group A （RBP4〈811 pg/L）, group B （RBP4：811-〈1 092 pg/L）, group C （RBP4：1 092-〈1 356 pg/L）, and group D （RBP4~〉 1 356 IJg/L）. Clinical features were compared between four groups and influencing factors of coronary atherosclerosis index （CAD were detected. Results Serum triglycerides （TG）, blood urea nitrogen （BUN）, serum creatinine （sOr）, blood uric acid （BUA） and 2 hour C peptide （2hOP） in group D were significantly higher than those in group A （all P〈0.05）, but estimated glomerular filtration rate （eGFR） in group D was significantly lower than those in group A and C （all P〈0.05）. After adjustment of age and gender, partial correlation analysis showed that RBP4 （r = 0.204）, fasting plasma glucose （r = 0. 250） and glycosylated hemoglobin （r = 0. 242） were positively correlated with coronary atherosclerosis index （CAI, all P〈0.05）. Multivariate stepwise regression analysis showed that RBP4 （β = 0. 201 ） was independently correlated with CAI （P〈0.05）. Age （β = - 0. 409） and RBP4 （β = -0.259） were independently correlated with eGFR （all P〈0.01 ）. Conclusion Patients with higher levels of serum RBP4 have elevated TG. TG is independently correlated with serum RBP4. Serum RBP4 levels are independently correlated with the severity of coronary artery disease and eGFR.