冠心病患者血浆内脏脂肪组织丝氨酸蛋白酶抑制剂和三酰甘油葡萄糖乘积指数的临床意义

Clinical significance of plasma visceral adipose tissue serine protease inhibitor and triglyceride glucose product index in patients with coronary atherosclerotic heart disease

目的探讨血浆内脏脂肪组织丝氨酸蛋白酶抑制剂(Vaspin)和三酰甘油葡萄糖乘积(TyG)指数在冠心病(冠状动脉粥样硬化性心脏病)中的临床意义。方法选取2021年11月至2022年5月山西医科大学第二医院心内科收治的胸痛患者97例,根据冠状动脉造影结果分为非冠心病组(22例)和冠心病组(75例)。冠心病患者根据Gensini评分分为轻度病变组(27例)、中度病变组(23例)和重度病变组(25例)。收集患者临床资料,计算TyG指数,检测血浆Vaspin水平。采用多因素二元Logistic回归模型分析冠心病的影响因素。分析血浆Vaspin、TyG指数与各指标的相关性。受试者工作特征曲线分析血浆Vaspin、TyG指数对冠心病的诊断价值。结果冠心病组血浆Vaspin水平低于非冠心病组[(7.2±1.8)μg/L比(9.0±1.6)μg/L],TyG指数高于非冠心病组[(8.97±0.46)比(8.48±0.27)],差异均有统计学意义(均P<0.001)。轻度病变组、中度病变组、重度病变组三酰甘油、TyG指数均高于非冠心病组,血浆Vaspin水平低于非冠心病组,重度病变组高密度脂蛋白胆固醇(HDL-C)水平低于非冠心病组,差异均有统计学意义(均P<0.05)。血浆Vaspin与HDL-C呈正相关,与冠心病呈负相关;TyG指数与HDL-C呈负相关,与冠心病呈正相关(均P<0.05)。多因素二元Logistic回归分析结果显示血浆Vaspin和TyG指数为冠心病的独立影响因素(均P<0.05)。血浆Vaspin、TyG指数及二者联合诊断冠心病的曲线下面积分别为0.763(95%置信区间:0.661~0.865)、0.829(95%置信区间:0.747~0.911)、0.895(95%置信区间:0.828~0.961),联合检测的曲线下面积高于二者单独检测。结论冠心病患者血浆Vaspin水平降低、TyG增高,二者均是冠心病的独立影响因素,二者联合检测可用于辅助诊断冠心病。

Objective To investigate the clinical significance of visceral adipose tissue serine protease inhibitor(Vaspin)and triglyceride glucose product(TyG)index in coronary atherosclerotic heart disease(CHD).Methods From November 2021 to May 2022,97 patients with chest pain admitted to Department of Cardiology,Second Hospital of Shanxi Medical University were enrolled.They were divided into non-CHD group(22 cases)and CHD group(75 cases)according to the results of coronary angiography,and patients with CHD were divided into mild lesion group(27 cases),moderate lesion group(23 cases)and severe lesion group(25 cases)according to Gensini score.Clinical data of patients were collected,TyG index was calculated and plasma Vaspin level was detected.Multivariate binary Logistic regression model was used to analyze influencing factors of CHD.Relationships of plasma Vaspin and TyG index to varions indexes were analyzed.Receiver operating characteristic curve was used to analyze diagnostic value of plasma Vaspin and TyG index for CHD.Results The level of plasma Vaspin in CHD group was lower than that in the non-CHD group[(7.2±1.8)μg/L vs(9.0±1.6)μg/L]and TyG index in CHD group was higher than that in the non-CHD group[(8.97±0.46)vs(8.48±0.27)](both P<0.001).The triacylglycerol and TyG index were higher in mild lesion group,moderate lesion group and severe lesion group than those in non-CHD group,and the level of plasma Vaspin were lower than that in non-CHD group;the level of high-density lipoprotein cholesterol(HDL-C)in severe lesion group was lower than that in non-CHD group(all P<0.05).The plasma Vaspin was positively correlated with HDL-C and negatively correlated with CHD;TyG index was negatively correlated with HDL-C and positively correlated with CHD(all P<0.05).Multivariate binary Logistic regression analysis showed that plasma Vaspin and TyG index were the independent influencing factors of CHD(both P<0.05).The areas under the curve(AUC)of plasma Vaspin,TyG index and their combined diagnosis of CHD were 0.763(95%confidence interval:0.661-0.865),0.829(95%confidence interval:0.747-0.911)and 0.895(95%confidence interval:0.828-0.961),respectively,and the AUC of combined detection was higher than that of single detection.Conclusions The level of plasma Vaspin decreases and TyG index increases in patients with CHD.Both of them were independent influencing factors of CHD.The combined detection of the two can be used to assist in the diagnosis of CHD.