冠心病合并非酒精性脂肪性肝病患者的胃饥饿素/肥胖抑制素比值变化及临床意义

The changes and clinical significance of Ghrelin/obestatin in patients with coronary heart disease complicated with non-alcoholic fatty liver disease

目的探讨冠心病合并非酒精性脂肪性肝病(NAFLD)患者胃饥饿素(Ghrelin)/肥胖抑制素(obestatin)比值变化及临床意义。方法收集冠心病患者112例作为研究对象,根据是否合并NAFLD分为冠心病NAFLD组(n=52)和单纯冠心病组(n=60),另选择同期健康志愿者50例作为对照组。采用酶联免疫吸附法(ELISA)测定血清Ghrelin、obestatin水平。根据冠脉造影结果,采用Gensini积分评估冠脉病变程度。结果冠心病NAFLD组、单纯冠心病组患者的Ghrelin/obestatin比值显著低于对照组;冠心病NAFLD组患者的Gensini积分明显高于单纯冠心病组,差异均有统计学意义(P<0.05)。冠心病NAFLD组患者的Ghrelin/obestatin比值与Gensini积分呈负相关(r=-0.59,P<0.05)。结论冠心病合并NAFLD患者的Ghrelin/obestatin比值与冠状动脉病变程度密切相关。Ghrelin/obestatin比值在预测冠心病合并NAFLD中有一定的辅助参考价值。

Objective To investigate the change ratio and clinical significance of Ghrelin/obestatin in patients with coronary heart disease complicated with non-alcoholic fatty liver disease（NAFLD）.Methods 112 cases of coronary heart disease patients were collected as research subjects,and according to whether it was complicated with NAFLD,they were divided into coronary heart disease complicated with NAFLD group（n = 52） and simple coronary heart disease group（n = 60）; 50 cases of healthy volunteers as a control group were selected at the same period.ELISA method was used to determine serum Ghrelin and obestatin levels.Gensini score was used to evaluate the extent of coronary lesions according to the results of coronary angiography.Results The Ghrelin/obestatin ratio of coronary heart disease complicated with NAFLD group and simple coronary heart disease group were significantly lower than the control group; the Gensini scores of coronary heart disease complicated with NAFLD group were significantly higher than simple coronary heart disease group,and the difference was statistically significant（P〈0.05）.The Ghrelin/obestatin ratio of patients with coronary heart disease complicated with NAFLD was negatively correlated with Gensini score（r =-0.59,P〈0.05）.Conclusion Ghrelin/obestatin ratio is closely related to the degree of coronary artery disease in patients with coronary heart disease complicated with NAFLD.Ghrelin/obestatin ratio has a supplementary reference value in predicting coronary heart disease combined with NAFLD.