血浆脂联素与冠状动脉病变程度的相关性分析

目的:通过测定冠状动脉造影患者的血浆脂联素(adiponectin,APN)浓度,进一步探索其对冠状动脉病变的影响.方法:收集105例冠状动脉造影患者的术前血浆,采用酶联免疫法测定APN浓度,冠状动脉病变程度用病变血管支数和 Gensini积分表示.结果:正常组APN浓度显著高于单支、双支、三支病变组(P值分别为0.012、0.004]、0.000 5),且随病变支数的增加, APN浓度有逐渐降低趋势.Gensini积分≥30分组APN浓度明显低于《30分组及0分组(P《0.05).急性冠状动脉综合征组(acute coronary syndrome,ACS) APN浓度明显低于非ACS组(0.731±0.361)mg/L与(1.097±0.617) mg/L,P=0.03).Logistic回归分析证实,低水平APN浓度是冠状动脉狭窄及斑块不稳定的独立危险因素.冠心病危险因素相关分析显示,APN与高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)呈正相关,与甘油三脂(triglyceride,TG)、C反应蛋白呈负相关.结论:血浆APN水平与冠状动脉粥样硬化及其严重程度和斑块稳定性独立相关,同时与C反应蛋白、TG、HDL-C也存在明确关系.

Association between plasma adiponectin levels and coronary lesion complexity

OBJECTIVE: To explore the association between the levels of plasma adiponectin and coronary artery lesion complexity in patients undergoing coronary angiography. METHODS: We measured the plasma concentrations of adiponectin in 105 candidates 28 healthy controls and 77 patients with coronary artery diseases (CAD)]. The complexity of coronary artery lesion was evaluated by the numbers of vessel disease and Gensini score. RESULTS: Plasma concentrations of adiponectin in healthy group were significantly higher than those in CAD patients. Among patients with CAD, those with multiple vessel lesions had significantly lower adiponectin levels than those with a single vessel lesion. Plasma concentrations of adiponectin in Gensini score > or = 30 group were significantly lower than those in <30 group and control group(P<0.05). Patients with acute coronary syndrome (ACS) had lower adiponectin levels than those without ACS (0.731+/-0.361) mg/L vs. (1.097+/-0.617) mg/L,P=0.03]. Logistic analysis indicated that the lower level of adiponectin was independent risk factor of coronary stenosis (OR 0.214, 95% CI 0.071-0.646, P=0.006) and unstable plaque (OR 0.151, 95% CI 0.044-0.515, P= 0.003). Adiponectin concentrations were correlated positively with high density lipoprotein cholesterol(HDL-C) and negatively with C-reactive protein and triglyceride(TG). CONCLUSION: The decreased plasma adiponectin concentration might be associated with the coronary artery lesion and be used as an independent predictor of the occurrence and severity of coronary atherosclerosis and the stability of plaque.