COPD患者血浆chemerin水平的变化及其与患者脂代谢的关系

Plasma level of chemerin in COPD patients and the relationship between chemerin and lipid metabolism

目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者血浆趋化素(chemerin)水平的变化及其与患者脂代谢的关系。方法:随机选取COPD患者150例作为COPD组,另选取30例同期体检健康者作为对照组。COPD组根据其体质量指数(body mass index,BMI)分为消瘦组(BMI<18.5 kg/m2,n=116)和非消瘦组(BMI≥18.5 kg/m2,n=34)两个亚组。采用ELISA检测对照组和COPD组急性加重期和稳定期的血浆chemerin和总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等血脂水平,统计COPD组半年内再住院率和病死率等预后情况,并采用Pearson线性相关分析法分析其血浆chemerin水平与其血脂水平的关系和Spearman秩相关法分析其血浆chemerin和脂质水平与其预后的关系。结果:与对照组比较,COPD组急性加重期和缓解期的血浆TC,TG,HDL水平均降低,血浆chemerin和LDL水平则升高(P<0.05);与非消瘦组比较,消瘦组性加重期和缓解期的血浆TC,TG,HDL水平均降低,血浆chemerin和LDL水平则升高(P<0.05)。消瘦组半年内再住院率和病死率均较非消瘦组高,且COPD组半年内再住院患者和死亡患者的血浆TC,TG,HDL水平均低于半年内未住院患者和存活患者,血浆chemer in和LDL水平则高于半年内未住院患者和存活患者(P<0.05)。Pearson线性相关分析结果显示:COPD患者血浆chemerin水平与其TC,TG,HDL水平均呈负相关(r=–0.695,–0.748,–0.722;P<0.05),与其血浆LDL水平则呈正相关(r=0.668,P<0.05)。Spearman秩相关法分析结果显示:COPD患者血浆TC,TG,HDL水平与其半年内再住院率和病死率均呈负相关(TC:r=–0.716,–0.737;TG:r=–0.748,–0.753;HDL:r=–0.736,–0.728;P<0.05),其血浆chemerin和LDL水平与其半年内再住院率和病死率均呈正相关(chemerin:r=0.753,0.766;LDL:r=0.742,0.755;P<0.05)。结论:COPD患者血浆chemerin水平较高且与其脂代谢状况相关,血浆chemerin和脂质水平均与COPD预后情况相关,这可能与chemerin作为脂肪细胞因子和可参与机体炎症反应及COPD患者营养不良引发血脂水平降低相关,COPD患者血浆chemerin水平可能反映其脂代谢情况并作为其预后评估的参考指标。

Objective： To explore the change of plasma level of chemerin in chronic obstructive pulmonary disease （COPD） patients and its relationship with lipid metabolism. Methods： A total of 150 COPD patients were randomly selected and set as the COPD group and 30 healthy persons were set as the control group. The COPD group was further divided into a thin group （BMI〈 18.5 kg/m2, n=116） and a normal weight group （BMI 18.5 kg/m2, n=34） according to their body mass index （BMI）. Enzyme-linked immunosorbent （ELISA） was used in detection of plasma chemerin, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein （LDL）, and high-density lipoprotein （HDL）. The hospitalization rate in a half year and the mortality was statistically analyzed. Pearson correlation analysis was applied to analyze the relationship between plasma level of chemerin and levels of blood lipids, and Spearman rank correlation method was used to analyze the relationship between the plasma levels of chemerin or lipids and the prognosis. Results： Compared with the control group, plasma levels of TC, TG and HDL in the COPD group in acute exacerbation and remission stage were reduced, while plasma levels of chemerin and LDL was elevated; compared with the thin group, plasma levels of TC, TG and HDL in the normal weight group were elevated, while plasma levels of chemerin and LDL were decreased. The hospitalization rate in half year and the mortality in the thin group were higher than that in the normal weight group, and the plasma levels of TC, TG and HDL in the COPD patients with hospitalization in half year or death were lower than that in COPD patients without hospitalization, while the plasma levels of chemerin and LDL was increased （P〈0.05）. Pearson correlation analysis showed that plasma level of chemerin in COPD patients was negatively correlated with plasma levels of TC, TG and HDL （r=-0.695, -0.748, -0.695, P〈0.05）, while positively correlated with plasma levels of LDL （r=0.668, P〈0.05）. Spearman rank correlation analysis showed that plasma levels of TC, TG and HDL in COPD patients and hospitalization rate in half year as well as the mortality were negatively correlated （TC： r=-0.716,-0.737; TG： r=-0.748,-0.753; HDL： r= -0.736, -0.728, P〈0.0S）, while the plasma level of chemerin or LDL and hospitalization rate in half year and the mortality were positively correlated （chemerin： r=0.753, 0.766; LDL： r=0.742, 0.755, P〈0.05）. Conclusion： Plasma levels ofchemerin in the COPD patients are correlated with lipid metabolism. Plasma levels of chemerin and lipid are related to prognosis of COPD. The plasma levels of chemerin in patients with COPD may reflect the lipid metabolism and could be served as the index for prognostic evaluation.