体质量与C1q肿瘤坏死因子相关蛋白1在心肌梗死患者中的交互作用

Study on the interaction between body weight and C1q tumour necrosis factorrelated protein 1 in patients with myocardial infarction

目的·探讨体质量与血清C1q肿瘤坏死因子相关蛋白1(C1q tumor necrosis factor-related protein 1,CTRP1)水平间的关系,以及其对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者预后的影响。方法·选取2018年1月—2020年1月在南京医科大学附属淮安第一医院确诊的200例STEMI患者,收集并分析患者的基本资料、实验室检测指标及心功能指标。患者出院后,需继续口服药物并定期行门诊或电话随访。根据出院后1年内是否发生严重不良事件(serious adverse event,SAE),将患者分为SAE组和无SAE组。采用多因素Logistic回归模型分析STEMI患者发生SAE的影响因素。采用森林图分析患者的性别、年龄、体质量与血清CTRP1水平的交互作用。结果·共192例患者完成随访。其中,24例(12.5%)患者发生SAE。与无SAE组相比,SAE组患者的年龄更大[(67.08±10.30)岁vs(62.99±9.04)岁,P=0.043]、体质量更低[(65.41±9.45)kg vs(70.49±10.23)kg,P=0.023]、CTRP1水平较高[(21.59±4.48)ng/mL vs(17.67±5.87)ng/mL,P=0.002]。经校正性别、年龄后,多因素Logistic回归分析显示高CTRP1水平是STEMI患者发生SAE的危险因素(P=0.003),而体质量不影响患者SAE的发生(P>0.05)。亚组分析的结果显示,体质量与CTRP1之间存在交互作用(P=0.011),且CTRP1水平是低体质量患者发生SAE的危险因素(HR=22.303,P=0.003)。结论·STEMI患者的体质量与血清CTRP1水平间存在交互作用;低体质量STEMI患者的血清CTRP1水平越高,则预后越差。

Objective·To investigate relationship between body weight and serum level of C1q tumor necrosis factor-related protein 1(CTRP1),and its effect on the prognosis of patients with ST-segment elevation myocardial infarction(STEMI).Methods·A total of 200 patients diagnosed as STEMI in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University from January 2018 to January 2020 were selected.Their basic data,laboratory indexes and cardiac function indexes were collected and analyzed.After discharge,patients should continue to take oral drugs and have regular outpatient or telephone follow-up.According to whether serious adverse event(SAE)occurred or not within 1 year after discharge,patients were divided into SAE group and non-SAE group.Multivariate Logistic regression model was used to analyze the influencing factors of SAE in STEMI patients.The interaction between gender,age and body weight of patients and the serum level of CTRP1 was analyzed by forest plot.Results·A total of 192 patients were followed up.Among them,24 patients(12.5%)developed SAE.Compared with the non-SAE group,patients in the SAE group were older[(67.08±10.30)years vs(62.99±9.04)years,P=0.043],had lower body weight[(65.41±9.45)kg vs(70.49±10.23)kg,P=0.023],and had higher CTRP1 levels[(21.59±4.48)ng/mL vs(17.67±5.87)ng/mL,P=0.002].After adjusting for gender and age,multivariate Logistic regression analysis showed that high CTRP1 level was a risk factor for the incidence of SAE in STEMI patients(P=0.003),while body weight had no effect on the incidence of SAE(P>0.05).The results of subgroup analysis showed that there was an interaction between body weight and CTRP1(P=0.011),and CTRP1 level was a risk factor for SAE occurring in patients with lower body weight(HR=22.303,P=0.003).Conclusion·There is an interaction between body weight and serum CTRP1 level in STEMI patients.The higher the level of serum CTRP1 in STEMI patients with lower body weight,the worse the prognosis they have.