急性冠脉综合征患者血清ANGPTL3与炎症激活、糖脂代谢紊乱的相关性研究

Correlation between serum ANGPTL3 and inflammatory activation and glucose and lipid metabolism disorders in patients with acute coronary syndrome

目的探讨急性冠脉综合征(ACS)患者血清血管生成素样蛋白3(ANGPTL3)水平及其与ACS患者炎症激活、糖脂代谢紊乱的相关性。方法纳入ACS患者60例,分为不稳定心绞痛组(UA,n=29)和急性心肌梗死组(AMI,n=31),对照组选取同期冠脉造影阴性者(Control,n=30)。收集所有患者的血清,检测血清ANGPTL3水平、炎症指标(包括超敏C反应蛋白hs-CRP、肿瘤坏死因子TNF-α和白介素IL-6)和糖脂代谢指标[包括空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)],并探讨ACS患者血清ANGPTL3与炎症指标、糖脂代谢紊乱的相关性。结果与Control组相比,UA和AMI组患者血清ANGPTL3的水平升高(P<0.05),且AMI组升高更明显(P<0.05)。与Control组相比,UA和AMI组患者血清炎症因子hs-CRP、TNF-α和IL-6水平明显升高(P<0.05),且AMI患者升高更明显(P<0.05)。与Control组相比,UA和AMI组患者糖脂代谢指标包括FPG、TC、TG和LDL-C水平明显升高(P<0.05),AMI患者升高更明显(P<0.05);而UA和AMI组的HDL-C水平降低(P<0.05)。相关性分析发现ACS患者血清ANGPTL3与炎症因子hs-CRP(r=0.603,P<0.001)、TNF-α(r=0.890,P<0.001)和IL-6(r=0.793,P<0.001)水平、糖脂代谢指标FPG(r=0.706,P<0.001)、TC(r=0.729,P<0.001)、TG(r=0.756,P<0.001)和LDL-C(r=0.736,P<0.001)呈正相关;而与HDL-C(r=-0.828,P<0.001)呈负相关。结论ACS患者血清ANGPTL3水平升高,与激活的炎症反应、糖脂代谢紊乱严重程度密切相关,未来联合检测ANGPTL3对早期判断ACS患者炎症状态和糖脂代谢紊乱的严重程度具有一定的临床应用价值。

Objective To investigate the level of serum angiopoietin-like protein 3(ANGPTL3)in patients with acute coronary syndrome(ACS)and its correlation with inflammation activation and disorder of glucose and lipid metabolism in patients with ACS.Methods Sixty patients with ACS were included and divided into unstable angina pectoris group(UA,n=29)and acute myocardial infarction group(AMI,n=31),and the control group selected those with negative coronary angiography(Control,n=30).Collect serum from all patients to detect serum ANGPTL3 level,inflammation indicators(including hypersensitive C-reactive protein hs-CRP,tumor necrosis factor TNF-αand interleukin IL-6)and glucose and lipid metabolism indicators(including fasting blood glucose FPG,total cholesterol TC,Triglyceride TG,low-density lipoprotein cholesterol LDL-C and high-density lipoprotein cholesterol HDL-C,etc.),and explore the relationship between serum ANGPTL3 and inflammation indicators,glucose and lipid metabolism disorders in ACS patients.Results Compared with the Control group,the serum ANGPTL3 level in the UA and AMI groups was increased(P<0.05),and the AMI group was more significantly increased(P<0.05).Compared with the Control group,the serum inflammatory factors hs-CRP,TNF-αand IL-6 levels in the UA and AMI groups were significantly increased(P<0.05),and the AMI patients were more significantly increased(P<0.05).Compared with the Control group,the glucose and lipid metabolism indexes of patients in the UA and AMI groups including FPG,TC,TG,and LDL-C levels were significantly increased(P<0.05),and the AMI patients were more significantly increased(P<0.05).The HDL-C level in the AMI group decreased(P<0.05).Correlation analysis found that serum ANGPTL3 and inflammatory factors hs-CRP(r=0.603,P<0.001),TNF-α(r=0.890,P<0.001)and IL-6(r=0.793,P<0.001)levels in ACS patients,Glycolipid metabolism index FPG(r=0.706,P<0.001),TC(r=0.729,P<0.001),TG(r=0.756,P<0.001)and LDL-C(r=0.736,P<0.001)It was positively correlated,but negatively correlated with HDL-C(r=-0.828,P<0.001).Conclusion The increase of serum ANGPTL3 level in ACS patients is closely related to the activated inflammatory response and the severity of glucose and lipid metabolism disorders.The future joint detection of ANGPTL3 has certain clinical application value for early judgment of the inflammation status and severity of glucose and lipid metabolism disorders in ACS patients.