血清维生素K2、补体C1q肿瘤坏死因子相关蛋白3和核心结合因子a1与冠状动脉钙化的相关性研究

Correlation of complement C1q tumor necrosis factor related protein 3, core binding factor a1 and vitamin K2 in human serum with coronary artery calcification

目的探讨人血清中维生素K2(VK2)、补体C1q肿瘤坏死因子相关蛋白3(CTRP3)和核心结合因子a1(Cbfa1)水平与冠状动脉钙化(CAC)的关系。方法选取2016年6～12月就诊哈尔滨医科大学附属第一医院,因胸痛行冠状动脉64排CT造影检查的患者100例,根据结果分为CAC组60例和非冠状动脉钙化组(NCAC组)40例。CAC组根据冠状动脉钙化积分又分为轻度组23例、中度组19例和重度组18例。采用酶联免疫吸附法测定各组患者血清CTRP3、Cbfa1和VK2水平,其他各项指标来源于病例资料,比较两组患者的血清CTRP3、Cbfa1、VK2和其他各项指标水平。分析血清VK2、CTRP3和Cbfa1之间以及与其他变量的相关性,多因素回归分析载脂蛋白A、载脂蛋白B/载脂蛋白A、同型半胱氨酸、VK2与CAC之间的关系。结果与NCAC组比较,CAC组年龄偏大、合并高血压和糖尿病较多,CAC组血清总胆固醇、空腹血糖、同型半胱氨酸、钙离子水平和载脂蛋白B/载脂蛋白A比值均升高,高密度脂蛋白胆固醇和载脂蛋白A水平均降低(均为P<0.05)。两组患者血清CTRP3和Cbfa1水平比较,差异无统计学意义(均为P>0.05),但CAC组血清VK2水平较NCAC组明显降低[(2.92±0.80)μg/L比(3.57±0.59)μg/L,P=0.012]。Pearson相关性分析显示,血清VK2水平与糖尿病呈负相关(r=-0.317,P=0.046),血清CTRP3水平与空腹血糖呈负相关(r=-0.561,P=0.048),血清Cbfa1与ALP呈负相关(r=-0.673,P=0.023)。Logistic回归分析显示,VK2是CAC的独立影响因素(OR:0.251,95%CI:0.074～0.844,P=0.025)。结论血清CTRP3、Cbfa1水平与CAC无相关性,VK2水平与CAC呈负相关,可作为CAC的独立预测因子。

Objective To explore the correlation of vitamin K2(VK2),complement C1q tumor necrosis factor related protein 3(CTRP3)and core binding factor a1(Cbfa1)in human serum with coronary artery calcification(CAC).Methods From June to December 2016,100 hospitalized patients in First Affiliated Hospital of Harbin Medical University who had chest pain symptoms and underwent coronary computed tomography angiography(CCTA)were enrolled.The patients were divided into two groups according to the results of CCTA examination:60 patients in the CAC group and 60 patients in the NCAC group.The patients in group CAC were divided into three groups based on the CAC score:mild group has 23 patients,moderate group has 19 patients,severe group has 18 patients.Serum CTRP3,Cbfa1 and VK2 levels were measured by Enzyme linked immunosorbent assay(ELISA),the other indexes were from clinical data,the changes of serum CTRP3,Cbfa1 and VK2 levels and the other indexes were analyzed.To analyse the correlation of serum VK2,CTRP3 and Cbfa1 with other variables.Multivariate regression was used to analyse the relationship between apolipoprotein A,apolipoprotein B/apolipoprotein A,homocysteine,VK2 and CAC.Results Patients were older and had higher incidence rate of hypertension and diabetes in CAC group than in NCAC group(P<0.05).The serum total cholesterol,fasting blood glucose,homocysteine,Ca 2+levels and apolipoprotein B/apolipoprotein A ratios in CAC group were all higher than those in NCAC group,the high density lipoprotein cholesterol and apolipoprotein A in CAC group were all lower than those in NCAC group(all P<0.05).There were no significant differences in serum CTRP3 and Cbfa1 levels between the two groups(both P>0.05),but serum VK2 levels in the CAC group were significantly lower than those in NCAC group[(2.92±0.80)μg/L vs.(3.57±0.59)μg/L,P=0.012].Pearson correlation analysis showed that serum VK2 level was negatively correlated with diabetes mellitus(r=-0.317,P=0.046),serum CTRP3 level was negatively correlated with fasting blood glucose(r=-0.561,P=0.048),and serum Cbfa1 was negatively correlated with ALP(r=-0.673,P=0.023).Logistic regression analysis showed that VK2 was an independent influencing factor of CAC(OR:0.251,95%CI:0.074-0.844,P=0.025).Conclusions There is no correlation between serum CTRP3 and Cbfa1 levels and CAC.Serum VK2 level is negatively correlated with CAC,which could be used as an independent predictor of CAC.