血清艾帕素⁃12水平与冠状动脉钙化的相关性研究

Study on correlation between serum apelin⁃12 level and coronary artery calcification

目的:探究血清血管活性多肽艾帕素⁃12(apelin⁃12)与冠状动脉钙化(coronary artery calcification,CAC)之间的相关性。方法:选取于2015年1月至2018年12月在上海交通大学医学院附属瑞金医院心血管内科住院并行冠状动脉CT成像的197例患者,根据Agatston评分法将患者分为CAC评分(CAC score,CACS)≤100分(n=72)与CACS>100分(n=125)2组,收集2组患者相关临床指标,采用酶联免疫吸附法(enzyme⁃linked immunosorbent assay,ELISA)检测患者血清艾帕素⁃12水平,探究其与CAC及其相关心血管事件之间的关系。结果:2组患者基线特征显示,与CACS≤100分组相比,CACS>100分组患者的血清艾帕素⁃12水平[79.50(68.35,97.49)ng/L比91.94(80.13,110.19)ng/L]明显降低,差异有统计学意义(P=0.002)。二元Logistic回归分析显示,在未经调整的模型中,艾帕素⁃12水平与CAC的发生相关(OR=0.988,95%CI:0.978~0.997,P=0.013),调整了基线有差异的指标后,血清艾帕素⁃12水平与CAC的发生仍独立相关。Kaplan⁃Meier生存分析发现,较低的艾帕素⁃12水平与较高的心血管事件发生风险相关(Log rank检验,P=0.019)。在CACS>100分的亚组中,艾帕素⁃12水平与结局事件发生风险有关(Log rank检验,P=0.035)。采用Cox回归分析来确定艾帕素⁃12水平在不同亚组中的预测作用,发现艾帕素⁃12水平对结局事件的预测作用在年龄>65岁、肾功能不全、糖尿病患者中更强。结论:血清艾帕素⁃12与CAC及相关心血管事件之间存在相关性,艾帕素⁃12可能是预测CAC及其预后的生物标志物。

Objective To investigate the correlation between serum vasoactive polypeptide⁃12(apelin⁃12)and coronary artery calcification(CAC).Methods Totally 197 cases of patients,who were treated with coronary artery CT angiography(CTA)in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January 2015 to December 2018 were selected.According to Agatson score,the patients were divided into two groups,which were CAC scores≤100(n=72)and CAC scores>100(n=125).The relevant clinical indexes of patients were collected,and the serum apelin⁃12 level was detected by enzyme⁃linked immunosorbent assay to explore its relationship with CAC and its related cardiovascular events.Results The baseline characteristics in two groups showed that serum apelin⁃12 level in CAC scores>100 group was lower than that in CAC scores≤100 group[79.50(68.35,97.49)ng/L vs 91.94(80.13,110.19)ng/L],which showed significant difference(P=0.02).Binary Logistic regression analysis showed that apelin⁃12 levels were associated with the occurrence of CAC in the unadjusted model(P=0.013).After adjusting for the indicators with baselines difference,apelin⁃12 levels were still associated with the occurrence of CAC.Kaplan⁃Meier survival analysis found that compared to higher apelin⁃12 levels,lower apelin⁃12 levels were associated with an increased risk of cardiovascular events(Log rank test,P=0.019).In subgroups with CAC scores>100,apelin⁃12 levels were associated with an increased risk of outcome events(Log rank test,P=0.035).Cox regression analysis was used to determine the predictive effect of apelin⁃12 levels in different subgroups and found that the predictive effect of apelin⁃12 levels on outcome events was found to be stronger in patients aged>65 years,with renal insufficiency and diabetes mellitus.Conclusions Serum apelin⁃12 is correlated with CAC and related cardiovascular events,suggesting that apelin⁃12 may be a biomarker for predicting CAC and its prognosis.