老年颈动脉硬化患者血清Vaspin、Apelin、Omentin-1水平与糖脂代谢及骨密度的关系

The relationship between serum Vaspin,Apelin,Omentin-1 levels and glucose and lipid metabolism and bone mineral density in elderly patients with carotid atherosclerosis

目的探讨老年颈动脉硬化患者血清脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)、脂肪因子(Apelin)、网膜素-1(Omentin-1)水平与糖脂代谢及骨密度的关系。方法选取2018年1月—2020年3月上海交通大学医学院附属瑞金医院卢湾分院老年科诊治老年颈动脉硬化患者140例作为病例组,再根据颈动脉内膜中层厚度(IMT)分为非增厚亚组51例和增厚亚组89例;另选取医院同期体检的健康者75例作为健康对照组。采用酶联免疫吸附法(ELISA)检测血清Vaspin、Apelin、Omentin-1水平,彩色多普勒超声诊断仪检测患者IMT,计算体质量指数(BMI),全自动生化分析仪检测糖脂代谢指标水平,超声分析系统检测并计算骨密度T值。结果病例组血清Vaspin、Apelin、Omentin-1水平低于健康对照组(t/P=7.865/0.000、8.203/0.000、5.245/0.000);增厚亚组血清Vaspin、Apelin、Omentin-1水平低于非增厚亚组(t/P=8.570/0.000、14.432/0.000、13.839/0.000);健康对照组、非增厚亚组、增厚亚组的FPG、FINS、HDL-C水平均依次降低(F/P=55.869/0.000、11.449/0.000、4.032/0.019),TC、TG水平依次升高(F/P=149.946/0.000、144.664/0.000);增厚亚组骨密度T值水平低于非增厚亚组(t/P=2.971/0.004),BMI高于非增厚亚组(t/P=5.101/0.000);血清Vaspin、Apelin、Omentin-1水平均与FPG、FINS、骨密度T值呈正相关(P<0.05),与TC、TG、LDL-C、BMI呈负相关(P<0.05);Apelin水平与HDL-C呈正相关(P<0.05)。结论老年颈动脉硬化患者血清Vaspin、Apelin、Omentin-1水平明显降低,可能影响老年颈动脉硬化患者的糖脂代谢和骨密度。

Objective To explore the serum levels of fat-specific serine protease inhibitor(Vaspin),adipokines(Apelin)and Omentin-1 in elderly patients with carotid atherosclerosis.The relationship with glucose and lipid metabolism and bone density.Methods From January 2018 to March 2020,140 elderly patients with carotid atherosclerosis diagnosed and treated in the Luwan Branch of Ruijin Hospital,Shanghai Jiaotong University School of Medicine were selected as the case group,and then divided into non-intestinal-media thickness(IMT)values.There were 51 cases in the thickening subgroup and 89 cases in the thickening subgroup.In addition,75 healthy patients who had physical examinations in the hospital during the same period were selected as the healthy control group.Use enzyme-linked immunosorbent assay(ELISA)to detect serum Vaspin,Apelin,and Omentin-1 levels,color Doppler ultrasound to detect patient IMT,calculate body mass index(BMI),automatic biochemical analyzer to detect glucose and lipid metabolism,and ultrasound analysis The system detects and calculates the bone density T value.Results Serum Vaspin,Apelin,and Omentin-1 levels in the case group were lower than those in the healthy control group(t/P=7.865/0.000,8.203/0.000,5.245/0.000);serum Vaspin,Apelin and Omentin-1 levels in the thickened subgroup were lower than those in the non-thickened Subgroups(t/P=8.570/0.000,14.432/0.000,13.839/0.000);FPG,FINS,HDL-C levels in the healthy control group,non-thickening subgroup,and thickening subgroup decreased sequentially(F/P=55.869/0.000,11.449/0.000,4.032/0.019),the levels of TC and TG increased sequentially(F/P=149.946/0.000,144.664/0.000);the bone mineral density T level of the thickened subgroup was lower than that of the non-thickened subgroup(T/P=2.971/0.004),BMI was higher than the non-thickening subgroup(t/P=5.101/0.000);serum Vaspin,Apelin,Omentin-1 levels were positively correlated with FPG,FINS,and bone mineral density T values(P<0.05),negatively correlated with TC,TG,LDL-C,BMI(P<0.05);Apelin level was positively correlated with HDL-C(P<0.05).Conclusion Serum Vaspin,Apelin and Omentin-1 levels in elderly patients with carotid atherosclerosis are significantly reduced,which may affect the glucose and lipid metabolism and bone mineral density in elderly patients with carotid atherosclerosis.