心外膜脂肪厚度与冠心病的相关性研究

Relationship between epicardial adipose tissue thickness and coronary artery disease

目的:探讨冠心病(CAD)及非冠心病(Non-CAD)患者心外膜脂肪组织(EAT)厚度与脂肪细胞因子脂联素(APN)、肿瘤坏死因子(TNF)-α、白细胞介素6(IL)-6水平及局部巨噬细胞浸润的关系。方法:应用心脏彩超测量EAT厚度;免疫组织化学法检测脂肪标本巨噬细胞浸润情况。通过逆转录-聚合酶链反应(RT-qPCR)检测EAT中APN、TNF-α、IL-6mRNA表达水平。免疫印迹(Western Blot)分析EAT中APN、TNF-α、IL-6蛋白表达水平;ELISA法检测外周静脉血APN、TNF-α、IL-6、高敏C-反应蛋白(hsCPR)浓度并常规检测生化指标。结果:CAD患者EAT厚度增加、巨噬细胞浸润增加。RT-qPCR检测显示CAD患者EAT中APN mRNA降低、TNF-α、IL-6mRNA升高。Western Blot分析显示CAD患者EAT中APN蛋白降低、TNF-α、IL-6蛋白升高。ELISA法检测显示CAD外周静脉血APN浓度降低、TNF-α、IL-6、hsCPR浓度升高。结论:CAD患者EAT厚度增加与局部脂肪细胞因子和炎性因子的分泌失调、巨噬细胞浸润增加密切相关。

Objective：This study investigated epicardial adipose tissue （EAT） thickness, adipokines expression and local macrophages infiltration in coronary artery disease （CAD） patients. Method： All patients underwent ech- ocardiographic measurement of epicardial adipose tissue thickness. EAT samples collected from CAD patients and non-CAD controls. Adiponectin（APN）, cytokines of interleukin-6 （IL-6） and necrosis factor-a （TNF-~） expres- sion level in EAT were measured using real-time quantitative （RT-qPCR） and western blot. Immunohistoehemis- try was used to detect CD68＋ cells in EAT samples. APN, TNF-a and IL-6 concentrations in peripheral veinplasma was measured with enzyme-linked immunosorbent assay. Peripheral vein plasma biochemistries were per- formed with routine laboratory techniques. Result： EAT was significantly higher in CAD group than that in Non- CAD. Histological examination revealed increased macrophage infiltration into epicardial adipose tissue of CAD pa- tients. Decreased adiponectin displayed by RT-qPCR and western blot was associated with enhanced cytokines of IL-6 and TNF-a. Conclusion： Endocrine disorders and increased macrophage infiltration in epicardial adipose tissue are strongly linked to epicardial adipose tissue thickness in CAD.