心型脂肪酸结合蛋白和沉默信息调节因子2相关酶1异常表达与心室重构的关系

Relationship of abnormal expression of serum H-FABP and SIRT1 with ventricular remodeling in elderly patients with ischemic cardiomyopathy

目的 研究血清心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)、沉默信息调节因子2相关酶1(silent mating type information regulation 2 homolog-1,SIRT1)的异常表达与老年缺血性心肌病患者心室重构的关系。方法 回顾性选取2022年8月至2023年12月苏州大学附属第二医院收治的老年缺血性心肌病患者200例为研究组,另选取苏州大学附属第二医院同期健康体检者100例为对照组;根据是否发生心室重构将研究组患者分为心室重构组38例和非心室重构组162例。检测并比较患者血清H-FABP、SIRT1表达水平,用Pearson相关性分析血清H-FABP、SIRT1表达水平与心室重构的关系,用ROC曲线分析血清H-FABP、SIRT1诊断心室重构的价值,用logistic回归分析发生心室重构的影响因素。结果 研究组血清H-FABP水平显著高于对照组,SIRT1水平显著低于对照组(P<0.01)。心室重构组血清H-FABP水平显著高于非心室重构组,SIRT1水平显著低于非心室重构组(P<0.01)。Pearson相关性分析显示,血清H-FABP水平与左心室质量指数呈负相关(r=-0.569,P=0.001),血清SIRT1水平与左心室质量指数呈正相关(r=0.511,P=0.001)。ROC曲线显示,血清H-FABP、SIRT1水平诊断心室重构的曲线下面积分别为0.872(95%CI:0.821~0.933)、0.848(95%CI:0.786~0.897)。Logistic回归分析显示,血清H-FABP是老年缺血性心肌病患者发生心室重构的危险因素(OR=1.848,95%CI:1.068~3.262,P=0.032),SIRT1是保护因素(OR=0.687,95%CI:0.409~0.935,P=0.015)。结论 老年缺血性心肌病患者血清H-FABP异常高表达,SIRT1异常低表达,表达水平与心室重构严重程度呈相关性,是导致心室重构的影响因素,且对心室重构具有良好的诊断价值。

Objective To investigate the relationship between abnormal expression of serum heart-type fatty acid-binding protein(H-FABP) and silent mating type information regulation 2 homolog-1(SIRT1) and ventricular remodeling in elderly patients with ischemic cardiomyopathy.Methods A total of 200 elderly patients with ischemic cardiomyopathy admitted to our hospital from August 2022 to December 2023 were enrolled as the study group,and another 100 healthy individuals who took physical examinations at the same time were recruited as the control group.According to ventricular remodeling occurred or not,the patients from the study group were divided into a ventricular remodeling subgroup(38 cases) and a non ventricular remodeling subgroup(162 cases).Serum H-FABP and SIRT1 levels were detected and compared in above groups and subgroups.Pearson correlation analysis was used to analyze the relationship between serum H-FABP and SIRT1 levels and ventricular remodeling,and ROC curve was plotted to analyze the serum H-FABP and SIRT1 levels in diagnosing ventricular remodeling.The influencing factors of ventricular remodeling were analyzed by logistic regression.Results The serum H-FABP level was significantly higher,and that of SIRT1 was obviously lower in the study group than the control group(P<0.01).The ventricular remodeling subgroup had higher serum H-FABP level but lower SIRT1 level when compared with the non ventricular remodeling subgroup(P<0.01).Pearson correlation analysis showed that serum H-FABP level was negatively correlated with LVMI(r=-0.569,P=0.001),while serum SIRT1 level was positively correlated with LVMI(r=0.511,P=0.001).ROC curve analysis indicated that the AUC value of serum H-FABP and SIRT1 levels in diagnosing ventricular remodeling was 0.872(95%CI:0.821-0.933) and 0.848(95%CI:0.786-0.897),respectively.Logistic regression analysis suggested that serum H-FABP(OR=1.848,95%CI:1.068-3.262,P=0.032) was a risk factor,while SIRT1 was a protective factor(OR=0.687,95%CI:0.409-0.935,P=0.015) for ventricular remodeling in elderly patients with ischemic cardiomyopathy.Conclusion Elderly patients with ischemic cardiomyopathy have abnormally high expression of serum H-FABP and abnormally low expression of SIRT1.The expression levels are correlated with the severity of ventricular remodeling,and are influencing factors for ventricular remodeling,and show good diagnostic value for ventricular remodeling.