急性冠状动脉综合征患者血清抵抗素水平与冠状动脉病变的相关性研究

目的探讨急性冠状动脉综合征(ACS)患者血清抵抗素水平与冠状动脉病变严重程度之间的相关性。方法选择因胸痛住院的患者220例,根据病史、体检及冠状动脉造影结果将患者分为正常对照组(67例)、稳定性心绞痛(SAP)组(70例)和ACS组(83例)。检测患者血脂、外周血白细胞、高敏C反应蛋白(hs-CRP)和血清抵抗素水平,并均经冠状动脉造影评价冠状动脉狭窄程度和病变血管数目。结果ACS组患者血清抵抗素水平显著高于SAP组和正常对照组[(1.18±0.48)μg/Lvs(0.66±0.40)μg/Lvs(0.49±0.40)μg/L,P<0.01],仅在ACS组中,血清抵抗素水平与外周血白细胞水平(r=0.347,P=0.001)和hs-CRP水平(r=0.262,P=0.004)呈显著正相关。血清抵抗素水平随狭窄>50%的冠状动脉数目的增多而升高(P<0.01),logistic回归分析显示,血清抵抗素水平是ACS强的危险因素(OR=29.132,95%CI:10.939~77.581,P=0.000)。结论血清抵抗素水平与炎性反应和冠状动脉病变严重程度密切相关,是ACS强的危险预测因素。     

冠状动脉慢血流患者血清炎性标志物的检测水平及意义

目的:探讨重要炎症因子高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)及肿瘤坏死因子-α(TNF-α)在冠状动脉慢血流(CSF)发生发展中的作用及临床意义。方法:选择经冠状动脉造影(CAG)检查诊断为CSF患者20例,CAG显示无管腔狭窄及无慢血流的正常血流速度(NCF)者24例为对照组,使用校正的TIMI血流分级(CTFC)方法评价冠状动脉血流速度,并分别测定2组的血清高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)及肿瘤坏死因子-α(TNF-α)。结果:2组在年龄、性别、高血压史、早发冠心病家族史、吸烟及血脂等方面均无明显差别。CSF组血清MMP-9、TNF-α水平较NCF组明显增高(P<0.05),但2组的hs-CRP、IL-6水平差异无统计学意义。结论:血清MMP-9、TNF-α2种炎症因子可能介导或参与了CSF形成的发生、发展过程,对血清MMP-9、TNF-α水平的检测及对CSF的诊断有一定的判断作用,值得临床进一步地探讨。     

Pitavastatin improves serum resistin levels in patients with hypercholesterolemia

AIM: Resistin in serum is associated with high risk in patients with atherosclerosis. This clinical study aimed to investigate whether pitavastatin can regulate the serum level of resistin, together with levels of other inflammatory cytokines and adipocytokines. METHODS: Forty two outpatients (mean age 65.2 +/- 12.6 yr, M/F: 21/21) with hypercholesterolemia were administered 2 mg of pitavastatin and serum levels of resistin, together with serum levels of adiponectin, leptin, TNF-alpha and hsCRP, were measured before, and 12 weeks after enrollment. RESULTS: There was no significant gender-related difference in initial serum resistin levels. Pitavastatin significantly decreased LDL-cholesterol after 12 weeks. Initial levels of resistin showed a significant correlation with those of hsCRP (r=0.38, p=0.013), but not TNF-alpha or HOMA-R. Serum resistin, but not adiponectin and leptin, levels were significantly decreased, dropping from 17.1 +/- 9.9 ng/ dL to 15.2+/-10.0 (p=0.001) after 12 weeks of administration. The patient group with a baseline hsCRP > or = 0.1 at enrollment (n=17) had decreased levels of both resistin and hsCRP (p=0.011 and p=0.022, respectively). CONCLUSION: This study showed the pleiotropic effect of pitavastatin on the serum resistin concentration, suggesting that it may assist in the prevention of atherosclerosis.     

冠状动脉支架置入术对冠心病患者术后早期血清抵抗素水平的影响

目的 评价经皮冠状动脉支架置入术(CSI)对血清抵抗素水平的影响.方法 选择2007年7月至2008年5月在我院行CSI的40例患者为研究对象(CSI组),同时选择一组同期进行冠状动脉造影(CAG)的40例患者作为对照(CAG组).采用酶联免疫(ELISA)法检测血清抵抗素和超敏C反应蛋白(HS-CRP)含量,并分别于CSI或CAG术前及术后1 h、6 h、24 h采集静脉血进行血清抵抗素和Hs-CRP含量的测定.结果 CSI组患者血清抵抗素水平术后6 h显著高于术前(30.4±9.2μg/L比23.4±6.4μg/L,t=9.03,P＜0.01),术后24 h Hs-CRP含量显著高于术前(15.2±4.1 mg/L比7.4±3.4 mg/L,P＜0.01),并达到高峰.CAG组患者造影后与造影前比较,血清抵抗素水平差异无统计学意义(P＞0.05).结论 冠状动脉支架置入术后血清抵抗素水平升高,提示术后有炎症刺激反应.     

急性冠状动脉综合征患者血清抵抗素水平研究

目的探讨急性冠状动脉综合征患者血清抵抗素水平的变化及其可能的病理生理意义。方法酶联免疫法测定37例急性冠状动脉综合征患者,其中急性心肌梗死19例(急性心肌梗死组),不稳定性心绞痛18例(不稳定性心绞痛组)和26例正常对照组的空腹血清抵抗素水平。结果急性冠状动脉综合征患者血清抵抗素水平[(11.60±5.98)μg/dl]高于正常对照组[(4.17±2.24)μg/dl,P<0.05],其中急性心肌梗死组抵抗素水平[(15.12±5.06)μg/dl]明显高于不稳定性心绞痛组[(7.67±4.28)μg/dl,P<0.05];抵抗素水平与心肌肌酸激酶及其同工酶、肌钙蛋白I峰值呈正相关(分别r=0.541,P<0.01;r=0.508,P<0.01;r=0.545,P<0.01),与体内脂肪百分比及高密度脂蛋白胆固醇呈负相关(分别r=-0.386,P<0.05;r=-0.335,P<0.05)。结论血清抵抗素水平与心肌损伤大小、体内脂肪分布和高密度脂蛋白胆固醇有关,提示抵抗素可能参与了动脉粥样硬化和急性冠状动脉综合征的发病。     

Increased osteoprotegerin serum levels in men with coronary artery disease

Osteoprotegerin (OPG) regulates osteoclast and immune functions and appears to represent a protective factor for the vascular system. However, the role of OPG in human atherosclerosis has not been evaluated. In this study, we assessed OPG serum levels in 522 age-matched men who, on the basis of coronary angiography, had either absence of coronary artery disease (CAD) or presence of single-vessel disease, double-vessel disease, or severe triple-vessel disease. OPG serum levels were positively correlated with age (r = 0.28; P < 0.001) and were higher in men with diabetes mellitus (P < 0.01). OPG serum levels in men without CAD were 5.4 +/- 2.0 pmol/liter, compared with 6.1 +/- 2.1 pmol/liter in single-vessel disease (P < 0.005), 5.9 +/- 2.4 in double-vessel disease (P < 0.05), and 6.3 +/- 2.3 pmol/liter in triple-vessel disease (P < 0.001). Moreover, OPG serum levels were positively correlated with the severity of CAD as determined by a CAD scoring system (r = 0.17; P < 0.01). In conclusion, our data underline that OPG serum levels are associated with the severity of CAD and are increased in elderly men and patients with diabetes mellitus. We conclude that increased OPG serum levels may reflect advanced cardiovascular disease in men.     

The serum levels of resistin in rheumatoid arthritis patients

OBJECTIVE: Adipocyte-derived resistin is a circulating protein implicated in insulin resistance, but the role of human resistin is uncertain because it is produced largely by macrophages. The aim of this study was to analyze serum resistin concentrations in rheumatoid arthritis (RA) patients to determine the role of resistin in human inflammatory diseases. MATERIALS AND METHODS: Resistin concentrations were assessed by ELISA in serum samples from 42 patients with RA. Serum samples from 38 healthy subjects acted as controls. We also evaluated the circulating levels of tumor necrosis factor- alpha (TNF-alpha) and disease activity markers in RA patients. RESULTS: In RA patients, serum resistin levels were significantly higher than those in healthy subjects. Serum resistin levels in RA patients were correlated with the RA disease activity markers, CRP and ESR. Furthermore, resistin levels in RA patients were significantly correlated with circulating levels of TNF-alpha. CONCLUSION: Serum resistin levels were significantly increased in RA patients and correlated with inflammatory markers and TNF-alpha, suggesting that resistin may play a role in the rheumatoid inflammatory process.     

Increased serum resistin levels in patients with type 2 diabetes are not linked with markers of insulin resistance and adiposity

Abstract The role of resistin in human biology remains uncertain. We measured serum resistin levels in Japanese patients with (n=111) and without (n=98) type 2 diabetes mellitus and investigated the significance of this hormone in the pathophysiology of diabetes. The levels of serum adiponectin and leptin were also measured. Resistin levels were increased significantly in patients with type 2 diabetes compared with non-diabetic subjects (24.7±2.6 vs. 15.0±1.2 ng/ml, p=0.0013). However, there was no correlation in either patient group between serum resistin levels and markers of insulin resistance, obesity or hyperlipidaemia. These results were in direct contrast to the data of leptin or adiponectin, both of which were closely related to these clinical markers of diabetes. Multivariate regression analysis on the combined data of the two groups demonstrated that the presence of diabetes and HDL cholesterol levels were significant predictors of serum resistin levels (diabetes: =0.159, p=0.035; HDL: =-0.172, p=0.039). No correlation was observed between C-reactive protein and resistin adjusted for BMI. Taken together, these findings demonstrate that serum resistin levels are increased in patients with type 2 diabetes, but this increase is not linked to markers of insulin resistance or adiposity. Further studies are necessary to elucidate the significance of serum resistin concentration in human pathophysiology.     

冠状动脉慢血流患者血清胆红素与抵抗素的含量测定

目的 探讨血清胆红素和血清抵抗素与冠状动脉慢血流现象的关系。方法 冠状动脉造影以及TIMI帧数测量确定慢血流患者以及血流正常者分别作为实验组（40例）和对照组（40例）。经过基础资料统计、常规生物化学检验、酶联免疫以及比色法测定并比较两组指标。结果 两组基础资料相当,吸烟率差异较大（P<0.05）;血清生物化学检验发现实验组血糖水平稍高于对照组（P<0.05）,抵抗素水平明显高于对照组（P<0.05）;而血清胆红素水平却远远低于对照组（P<0.01）,差异具有统计学意义。结论 血清胆红素水平降低以及吸烟率、抵抗素、血糖水平升高与冠状动脉慢血流关系密切。     

绝经后女性患者血清抵抗素水平与冠心病病变严重程度的相关性研究

目的评价绝经后女性患者血清抵抗素(Resistin)水平与冠心病病变严重程度的相关性,并探讨抵抗素水平与心血管病危险因素的关系。方法117例绝经后妇女,均检测血清抵抗素、胰岛素,并检测空腹血糖(BG)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(Fib)水平及总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及脂蛋白(a)[Lp(a)]等血脂水平指标。根据冠状动脉病变严重程度分为4组:第1组为冠状动脉无病变者,第2组为冠状动脉轻度病变者,第3组为冠状动脉中度病变者,第4组为冠状动脉重度病变者。有中、重度病变的患者诊断为冠心病。结果冠心病患者血清抵抗素水平显著高于无冠心病的患者[4(1~10)μg/L比2(0~4)μg/L,中位数(四分位数间距)]。多元logistic回归分析显示,血清抵抗素为冠心病独立危险因素(OR1.131;95%CI1.012~1.263)。抵抗素水平与冠状动脉病变程度呈正相关(r=0.231)。控制其他心血管病危险因素后,抵抗素仍然与冠状动脉病变程度呈正相关(r=0.246)。抵抗素水平与患者年龄及hs-CRP呈正相关(r值分别为0.204和0.166,P值分别为0.001及0.009)。结论绝经后妇女血清抵抗素水平可能为冠心病的独立危险因素,并且与冠状动脉病变的严重程度可能存在一定的正相关。由于抵抗素水平与hs-CRP水平呈正相关,故抵抗素可能通过炎症机制影响冠状动脉粥样硬化病变的进程。     

Increased serum resistin in elite endurance athletes with high insulin sensitivity

Aims/hypothesis Resistin is an adipokine associated with obesity and type 2 diabetes in animal models, but in humans its role remains uncertain. This study was undertaken to test whether serum resistin is related to insulin resistance and markers of low-grade inflammation in elite athletes taken as a model of extreme insulin sensitivity.Subjects materials and methods In 23 elite athletes (sprinters, middle-distance and marathon runners) and in 72 sedentary men including lean and obese individuals with NGT, and obese individuals with IGT or new-onset type 2 diabetes, we assessed insulin sensitivity using a whole-body insulin-sensitivity index (WBISI) derived from a 3-h OGTT; energy homeostasis was also assessed by means of indirect calorimetry, along with circulating adipokines and low-grade pro-inflammatory cyto-chemokines.Results Professional athletes had increased WBISIs (p<0.001) and lipid oxidation (p<0.03); they also showed higher serum resistin concentrations (p<0.001), although the pro-inflammatory chemokines were not increased in comparison with the other study groups. Resistin was independently associated only with fasting plasma NEFA. Increased resistin was detected in the middle-distance and marathon runners, but not in the sprinters when compared with the lean, young, sedentary individuals.Conclusions/interpretation Serum resistin concentration is increased in elite athletes, providing evidence against the notion that resistin levels reflect insulin resistance in humans, as seen in animal studies. Increased resistin was observed in aerobic-endurance, but not sustained-power athletes and this feature appeared to be independently associated with parameters of fatty acid metabolism.     

急性冠状动脉综合征患者载脂蛋白A5检测及其意义

目的 探讨血清载脂蛋白A5(APOA5)水平与急性冠状动脉综合征(ACS)患者血脂谱及高敏性C反应蛋白(hs-CRP)的关系.方法 入选587例受试对象,分为对照组(n=232)、稳定性心绞痛(SA)组(n=127)、不稳定性心绞痛(UA)组(n=116)和急性心肌梗死(AMI)组(n=112).抽血分离血清,分别采用ELISA法和免疫比浊法测定血清APOA5以及hs-CRP,并测定血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C).比较各组ApoA5、hs-CRP和血脂的血清浓度差异,分析三者之间的相互关系.结果 UA组[(340.6±63.5)μg/L]和AMI组[(373.2±73.8)μg/L]的ApoA5浓度明显高于对照组[(108.7±23.2)μg/L]和SA组[(78.3±20.2)μg/L](均P<0.05).UA组和AMI组的ApoA5与TG(r=0.63和0.67,P<0.05)和hs-CRP(r=0.57和0.55,P<0.05)呈正相关,而ApoA5与TC、HDL-c和LDL-C无明显相关(P>0.05).结论 ACS患者中血清ApoA5浓度显著升高,与血清TG或hs-CRP浓度显著正相关,提示ApoA5的代谢和生理功能在ACS期间均发生了变化,这可能与炎症反应增强有关.     

老年男性患者血清抵抗素与血脂水平的相关性研究

目的观察老年男性患者血清抵抗素与血脂水平的关系。方法选择老年(≥80岁)男性患者220例,根据血脂水平分为血脂异常组(80例)和血脂正常组(140例),使用酶联免疫法测定空腹血清抵抗素浓度,并分析两者关联。结果血脂异常组患者空腹血清抵抗素浓度较血脂正常组高[(7.16±0.77)ng/ml比(6.21±0.63)ng/ml,P<0.05],血清抵抗素浓度与总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平呈负相关(γ=-0.231,-0.254,-0.243,均为P<0.01),与三酰甘油水平呈正相关(γ=0.127,P<0.01),在控制了年龄、病史和相关用药后,高密度脂蛋白胆固醇与抵抗素水平独立相关(P=0.017)。结论老年男性血脂异常患者空腹血清抵抗素浓度升高,可能与脂代谢紊乱有关。     

Reduced serum resistin levels in diabetic patients: Study from western India

ObjectiveResistin is an adipocyte-derived peptide that might play a role in obesity and insulin resistance (IR); however, its role in humans is largely unknown. The aim of the study was to elucidate the role of serum resistin and explore its relationship with inflammatory marker C-reactive protein (CRP) and adipocytokine (leptin, adiponectin) in Indian diabetic patients.Design and methodsA total of 171 subjects including 41 controls, 41 obese and 89 Type 2 diabetes mellitus (T2DM) patients were recruited in this cross-sectional study. Fasting serum resistin, leptin, adiponectin, insulin and CRP were measured by enzyme immunoassay. The relation between these variables was studied by univariate and multiple regression analysis.ResultsSerum resistin levels were significantly reduced in non-obese treated T2DM patients. In the correlation analysis after controlling for age and BMI we found that resistin is significantly associated with leptin (0.687, p < 0.002) and CRP (0.549, p < 0.018) in only control females and with CRP (0.642, p < 0.01) in T2DM female patients. In multiple linear regression analysis resistin was independently predicted by the leptin (p < 0.01) and leukocyte (p < 0.004) in controls, treated T2DM patients.ConclusionReduced resistin and leptin levels in non-obese treated T2DM and significant association between these two in control and treated T2DM suggest interplay between these two adipocytokines. In addition, the weak association of resistin with diabetes indicates that it may be playing an indirect role in the pathogenesis of T2DM.     

急性冠脉综合征患者抵抗素和P-选择素的相关性研究

目的 研究急性冠脉综合征(ACS)患者血浆抵抗素(Resistin)与P-选择素(P-selectin)的水平及其相关性.方法 选择经冠脉造影证实的102例ACS患者,其中急性心肌梗死(AMI)50例、不稳定型心绞痛(UAP)52例;拟诊冠心病冠脉造影正常的对照组40例.酶联免疫吸附法(ELISA)测定血浆抵抗素和P-选择素水平,同时南我院检验中心统一检测血脂.结果 ①ACS患者血浆抵抗素水平明显高于对照组[(4.09±0.78)ng/ml比(3.17±0.35)ng/ml,P<0.05],其中AMI组水平明显高于UAP组[(4.49±0.76)ng/ml比(3.70±0.59)ng/ml,P<0.05].②ACS患者血浆P-选择素明显高于对照组[(129.97±6.72)ng/ml比(80.42±4.75)ng/ml,P<0.05],其中AMI组水平明显高于UAP组[(133.77±6.55)ng/ml比(126.31±4.56)ng/ml,P<0.05].③抵抗素与P-选择素(r=0.43)和甘油三酯呈正相关(r=0.28),与高密度脂蛋白(HDL)呈负相关(r=-0.45.结论 ①ACS患者血浆抵抗素和P-选择素表达均增加.②ACS患者血浆抵抗素和P-选择素呈正相关.     

Increased serum levels of eotaxin in patients with inflammatory bowel disease

BACKGROUND: The CC-chemokines eotaxin and eotaxin-2, produced by epithelial and phagocytic cells, are potent and selective chemoattractants for eosinophils and basophils. The eosinophil is a potent inflammatory cell thought to play an important role in the pathogenesis of inflammatory bowel disease (IBD). In this study we investigated the serum concentrations of eotaxin and eotaxin-2 in patients with Crohn disease and ulcerative colitis. METHODS: Thirty-one patients with Crohn disease, 35 patients with ulcerative colitis and 41 control patients were studied. Eotaxin and eotaxin-2 serum levels were measured with solid phase sandwich enzyme-linked immunosorbent assays. RESULTS: Significantly increased serum eotaxin levels were observed in both patients with Crohn disease (289.4+/-591.5 pg/ml) and ulcerative colitis (207.0+/-243.4 pg/ml) when compared with controls (138.0+/-107.8 pg/ml) (P < 0.01). Moreover, patients with active Crohn disease and ulcerative colitis showed significantly higher serum eotaxin levels than patients with quiescent disease (434.0+/-776.8 pg/ml versus 113.8+/-65.4 pg/ml in Crohn disease and 295.7+/-337.1 versus 121.2+/-91.9 pg/ml in ulcerative colitis, P < 0.05). In contrast, there was no significant difference in eotaxin-2 serum levels among patients with Crohn disease (863.5+/-448.2 pg/ml), ulcerative colitis (1028.3+/-431.4 pg/ml) and controls (981.4+/-539.4 pg/ml). CONCLUSIONS: Eotaxin is significantly increased in serum of patients with active Crohn disease and ulcerative colitis, suggesting that this cytokine may play a role in the pathogenesis of IBD.