冠状动脉粥样硬化心脏病患者血清CTRP1水平与糖脂代谢、胰岛素抵抗的关系

Relationship between serum CTRP1 level and glucolipid metabolism,insulin resistance in patients with coronary atherosclerotic heart disease(CAHD)

目的研究冠状动脉粥样硬化性心脏病(冠心病)患者血清补体C1q肿瘤坏死因子相关蛋白1(CTRP1)水平与糖脂代谢、胰岛素抵抗的关系。方法选取2017年5月—2019年4月笔者所在医院心内科经冠状动脉造影(CAG)确诊的冠心病患者120例为研究对象,依据糖尿病诊断标准将其分为A组(正常糖耐量)、B组(糖耐量异常)、C组(2型糖尿病),比较三组一般资料、临床资料[空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)、Gensini评分、血清CTRP1、脂联素(APN)],比较不同冠状动脉病变程度患者CTRP1、糖脂代谢、胰岛素抵抗的差异,分析冠心病患者CTRP1与糖脂代谢、胰岛素抵抗的关系。结果C组FBG、HbA1c、FINS、HOMA-IR、TG、TC、Gensini评分及血清CTRP1高于A组、B组,C组APN低于A组、B组,A组、B组上述指标差异也有统计学意义(P<0.05);随冠状动脉病变支数增多,患者FBG、HbA1c、HOMA-IR、TG、Gensini评分及血清CTRP1增加,而APN下降(P<0.05);Pearson相关分析显示,冠心病患者血清CTRP1水平与其FBG、HbA1c、TC、Gensini评分成正相关,而与APN成负相关(P<0.05)。结论随冠状动脉病变程度加重,冠心病患者血清CTRP1表达水平升高,且其与患者糖脂代谢、胰岛素抵抗有密切关系,可能共同参与冠心病发生和发展。

Objective To study relationship between serum complement C1q tumor necrosis factor-related protein 1(CTRP1)level and glucolipid metabolism,insulin resistance in patients with CAHD.Methods A total of 120 patients who were confirmed with CAHD by coronary angiography(CAG)in cardiology department of author's hospital from May 2017 to April 2019 were enrolled in the study.According to diagnostic criteria of diabetes mellitus,they were divided into group A(normal glucose tolerance),group B(abnormal glucose tolerance)and group C(type 2 diabetes mellitus).The general data,clinical data[fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),triglyceride(TG),total cholesterol(TC),Gensini score,serum CTRP1,adiponectin(APN)]were cpmpared among the three groups.The differences in CTRP1,glucolipid metabolism and insulin resistance were compared in patients with different coronary artery lesions degree.The relationship between CTRP1 and glucolipid metabolism,insulin resistance in CAHD patients was analyzes.Results FBG,HbA1c,FINS,HOMA-IR,TG,TC,Gensini scores and serum CTRP1 in group C were higher than those in group A and group B,while APN was lower than that in group A and group B.There were significant differences in the above indexes between group A and group B(P<0.05).With the increase of coronary artery lesion count,FBG,HbA1c,HOMA-IR,TG,Gensini scores and serum CTRP1 were increased,while APN was decreased(P<0.05).Pearson correlation analysis showed that serum CTRP1 level was positively correlated with FBG,HbA1c,TC and Gensini score in CAHD patients,while negatively correlated with APN(P<0.05).Conclusion With exacerbation of coronary artery lesion severity,expression level of serum CTRP1 in CAHD patients is increased.Ii is closely related to glucolipid metabolism and insulin resistance,which may be collectively involved in occurrence and development of CAHD.