血清Vaspin、Apelin、Chemerin水平与高血压患者发生CAC的相关性

Correlation among serum levels of Vaspin,Apelin,Chemerin and CAC in hypertensive patients

目的:研究血清丝氨酸蛋白酶抑制因子(Vaspin)、Apelin[G-蛋白偶联受体(APJ)的内源性配体]、趋化素(Chemerin)水平与高血压患者冠状动脉钙化(CAC)的相关性。方法:依据血管内超声检查,我院的179例高血压患者被分为CAC组(109例)和无CAC组(70例)。另选择同期体检健康者77例作为健康对照组。根据CAC积分(CACs),CAC组被分为轻度CAC组(36例)、中度CAC组(36例)与重度CAC组(37例)。观察比较三组和CAC三个亚组Vaspin、Apelin、Chemerin水平及CAC组CACs。分析三个CAC亚组上述指标血清水平与CACs的相关性及对高血压患者发生CAC的预测价值。结果:与健康对照组、无CAC组比较,CAC组血清Vaspin[(7.82±1.42)ng/ml比(8.04±1.62)ng/ml比(3.88±1.74)ng/ml]、Apelin[(45.84±7.57)ng/L比(43.66±9.64)ng/L比(34.93±6.88)ng/L]水平均显著降低,血清Chemerin水平[(198.77±41.67)ng/ml比(202.29±40.72)ng/ml比(241.33±52.35)ng/ml]显著升高(P均=0.001)。CAC三亚组间:血清Vaspin和Apelin水平均符合轻度CAC组>中度CAC组>重度CAC组,血清Chemerin水平和CACs均符合轻度CAC组<中度CAC组<重度CAC组,且两两比较均有显著差异,P均<0.01。Pearson相关分析显示血清Vaspin、Apelin水平与CACs呈显著负相关(r=-0.856,-0.720,P均=0.001),血清Chemerin水平与CACs呈显著正相关(r=0.785,P=0.001)。ROC曲线显示,血清Vaspin、Apelin、Chemerin水平及三者联合预测CAC的曲线下面积分别为0.895、0.763、0.803及0.944,敏感度分别为88.9%、68.8%、78.9%及93.5%,特异性分别为90.0%、90.0%、82.8%及84.3%。结论:随高血压患者CAC程度加重,血清Vaspin、Apelin水平显著降低,血清Chemerin水平显著升高,且三指标水平与CAC病变程度显著相关,对CAC有显著的预测价值。

Objective:To study correlation among serum levels of serine protease inhibitor(Vaspin),Apelin[Endogenous ligand of G-protein coupled receptor(APJ)],Chemerin and coronary artery calcification(CAC)in hypertensive patients.Methods:A total of 179 hypertensive patients were divided into CAC group(n=109)and no CAC group(n=70)according to intravascular ultrasound examine results.Another 77 healthy people undergoing physical examination in our hospital simultaneously were regarded as healthy control group.According to CAC score(CACs),CAC group was divided into mild CAC group(n=36),moderate CAC group(n=36)and severe CAC group(n=37).Serum levels of Vaspin,Apelin and Chemerin were observed and compared among three groups and 3 subgroup of CAC group,and CACs of CAC group were observed and compared.Correlation among serum levels of above indexes and CACs in subgroups of CAC group and predictive value of these indexes for CAC were analyzed.Results:Compared with healthy control group and no CAC group,there were significant reductions in serum levels of Vaspin[(7.82±1.42)ng/ml vs.(8.04±1.62)ng/ml vs.(3.88±1.74)ng/ml]and Apelin[(45.84±7.57)ng/L vs.(43.66±9.64)ng/L vs.(34.93±6.88)ng/L],and significant rise in serum Chemerin level[(198.77±41.67)ng/ml vs.(202.29±40.72)ng/ml vs.(241.33±52.35)ng/ml]in CAC group(P=0.001 all).Among CAC subgroups:serum Vaspin and Apelin levels were accorded with mild CAC group>moderate CAC group>severe CAC group,serum Chemerin level and CACs were accorded with mild CAC group<moderate CAC group<severe CAC group,there existed significant difference between any two groups,P<0.01 all.Pearson correlation analysis indicated that serum Vaspin and Apelin levels were significant inversely correlated with CACs(r=-0.856,-0.720,P=0.001 both),and serum Chemerin level were significant positively correlated with CACs(r=0.785,P=0.001).ROC analysis indicated that AUCs of serum Vaspin,Apelin and Chemerin levels and triple-detection were 0.895,0.763,0.803 and 0.944 respectively,sensitivities of them were 88.9%,68.8%,78.9%and 93.5%respectively,and specificities of them were 90.0%,90.0%,82.4%and 84.3%respectively for predicting CAC.Conclusion:Along with CAC aggravates,serum Vaspin and Apelin levels significantly reduce and serum Chemerin level significantly rises in hypertensive patients.Above index levels are significantly correlated with severity of CAC,and possess significant predictive value for CAC.