冠心病患者胰岛素抵抗指数与重组β细胞营养因子、脂蛋白相关磷脂酶A2的相关性分析

Analysis of the Correlation of Insulin Resistance Index to Serum Betatrophin and Lp-PLA2 in Coronary Heart Disease Patients

目的探讨冠心病(coronary heart disease,CHD)患者胰岛素抵抗指数(HOMA-IR)与重组β细胞营养因子及脂蛋白相关磷脂酶A2(Lp-PLA2)的相关性。方法选取2015年5月—2017年5月我院收治的CHD患者212例,根据是否伴胰岛素抵抗(IR)分为IR组133例和非IR组79例,另据HOMA-IR水平又分为<3.0组84例、3.0~5.0组81例、≥5.0组47例。比较各组一般资料、糖脂代谢指标及血清重组β细胞营养因子、Lp-PLA2水平,并分析血清糖代谢指标及重组β细胞营养因子、Lp-PLA2水平与HOMA-IR间的相关性。结果相较于非IR组,IR组体重指数(BMI)、腰臀比、低密度脂蛋白胆固醇(LDL-C)、超敏C-反应蛋白(hs-CRP)升高,高密度脂蛋白胆固醇(HDL-C)降低,差异均有统计学意义(P<0.01)。与非IR组比较,IR组空腹血糖(FPG)、空腹胰岛素(FPI)、HOMA-IR、HOMA-β、Lp-PLA2显著升高,Matsuda指数及血清重组β细胞营养因子显著降低,差异均有统计学意义(P<0.05或P<0.01)。与HOMA-IR<3.0组患者比较,HOMA-IR 3.0~5.0组及≥5.0组患者BMI、腰臀比、LDL-C和hs-CRP水平升高,HDL-C降低,差异均有统计学意义(P<0.05)。患者HOMA-IR数值越大,FPG、FPI、HOMA-β、Lp-PLA2水平越高,Matsuda指数及血清重组β细胞营养因子水平越低,差异均有统计学意义(P<0.05)。相关性分析显示,冠心病患者HOMA-IR与FPG、FPI、HOMA-β及血清Lp-PLA2水平呈显著正相关,与Matsuda指数及血清重组β细胞营养因子水平呈显著负相关。结论 CHD患者HOMA-IR与血清重组β细胞营养因子、Lp-PLA2水平密切相关。

Objective To investigate the correlation of insulin resistance(IR)index to serum recombinant Betatrophin and Lp-PLA2 in coronary heart disease(CHD)patients.Methods A total of 212 CHD patients admitted to our hospital from May 2015 to May 2017 were divided into IR group(n=133)and non-IR group(n=79)based on presence of IR.According to the HOMA-IR level,they were divided into<3.0 group(n=84),3.0-5.0 group(n=81),and≥5.0 group(n=47).Clinical data,glucolipid metabolic indexes,serum Betatrophin,and Lp-PLA2 level differences were compared between two groups.Correlation between serum Betatrophin,Lp-PLA2 and HOMA-IR were also analysed.Results As compared with non-IR group,IR group showed higher BMI,larger waist-hip ratio,higher LDL-C and hsCRP,and lower serum HDL-C(P<0.01).In addition,FPG,FPI,HOMA-IR,HOMA-βand Lp-PLA2 were significantly increased,whereas Matsuda index and serum recombinant Betatrophin were decreased remarkably(P<0.05 or P<0.01).BMI,waist-to-hip ratio and serum HDL-C,LDL-C and hs-CRP levels differed significantly in HOMA-IR 3.0-5.0 group and HOMA-IR≥5.0 group,as compared with those in HOMA-IR<3.0 group(P<0.05).Patients with larger HOMA-IR value showed higher FPG and FPI,larger HOMA-βvalue,and higher Lp-PLA2,but lower Matsuda index and serum Betatrophin(P<0.05).Conclusion Serum Betatrophin and Lp-PLA2 level were closely related to the IR indexes in CHD patients.