代谢综合征合并主动脉瓣退行性病变患者血浆中的chemerin升高

Serum chemerin is elevated in patients with metabolic syndrome complicated by degenerative aortic valve disease

目的：探讨脂肪因子chemerin与主动脉瓣退行性病变（degenerative aortic valve disease, DAVD）合并代谢综合征的相关性方法选取2012年7月~2013年7月在海南省医院心脏外科住院的96例代谢综合征的患者（其中48例合并DAVD）和48例成人健康志愿者纳入统计，代谢综合征无DAVD患者年龄56.33±6.14岁，其中男25例，女23例，代谢综合征合并DAVD患者年龄60.16±6.72岁其中男24例，女24例，健康成人年龄52.94±8.28岁，其中男23例，女25例，医院检验科检测血浆中总甘油三酯、总胆固醇、低密度脂蛋白-c、高密度脂蛋白-c、空腹血糖、C反应蛋白等生化指标，Elisa法检测血浆中chemerin水平。结果代谢综合征合并DAVD患者较不合并DAVD患者血清chemerin水平高。代谢综合征患者较健康受试者血清chemerin水平高。单元logistic回归分析表明性别、体质量指数、空腹血糖、C反应蛋白和chemerin是代谢综合征合并DAVD患者的危险因子、所有的变量进行退步法多元logistic回归分析表明chemerin仍然是代谢综合征合并DAVD患者的危险因子。单元线性回归分析表明代谢综合征合并DAVD患者中体质量指数，收缩压，C反应蛋白与血浆chemerin正相关，多元线性回归分析表明体质量指数（r=0.368, P＜0.001）和C反应蛋白（r=0.525, P＜0.001）仍然与血浆chemerin存在显著正相关。结论上升血浆chemerin可能是代谢综合征合并DAVD患者的预测因子。

Objective To investigate the association of serum chemerin with degenerative aortic valve disease （DAVD） in patients with metabolic syndrome. Methods From July, 2012 to July, 2013, 48 patients with metabolic syndrome （mean age 56.33＆#177;6.14 years, including 25 male and 23 female patients）, 48 patients with metabolic syndrome and DAVD （mean age 60.16＆#177; 6.72 years, 24 males and 21 females）, and 48 adult healthy volunteers （mean age 52.94 ＆#177; 8.28 years, 23 males and 25 females） were examined for triglyceride, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein, fasting glucose, C-reactive protein and other biochemical indexes. Serum chemerin levels were detected using ELISA for all the subjects. Results Patients with metabolic syndrome had higher levels of serum chemerin than the healthy subjects, and patients with DAVD had higher chemerin levels than those with DAVD. Multivariate logistic regression analysis showed that increased serum chemerin level is a predictor of aortic valve degeneration in patients with metabolic syndrome. Univariate linear regression analysis showed that serum chemerin levels, body mass index, systolic blood pressure, total triglyceride and C-reactive protein were associated with metabolic syndrome. Stepwise multiple linear regression analysis identified correlations of body mass index and C-reactive protein with serum chemerin level. Conclusion Elevated serum chemerin level can be a predictor for DAVD in patients with metabolic syndrome.