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|本期目录/Table of Contents|

血清瘦素及胰岛素抵抗与冠脉慢血流的相关性及其临床意义

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2018年第4期
页码:
430-433
栏目:
临床研究
出版日期:
2018-04-25

文章信息/Info

Title:
The clinical significance and correlation between serum leptin levels, insulin resistance and coronary slow flow
作者:
武力勇; 吴高祥; 阮志敏; 朱国富; 张明国; 张 倩; 郑 梅; 楚天舒
(昆明医科大学第二附属医院心内科，云南 昆明 650101)
Author(s):
WU Li-yong;  WU Gao-xiang;  RUAN Zhi-min;  ZHU Guo-fu;  ZHANG Ming-guo;  ZHANG Qian;  ZHENG Mei;  CHU Tian-shu
(Department of Cardiology, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China)
关键词:
瘦素; 冠状动脉慢血流; 胰岛素抵抗
Keywords:
leptin;  coronary slow flow;  insulin resistance
分类号:
R543
DOI:
-
文献标识码:
A
摘要:
目的 分析血清瘦素水平及胰岛素抵抗（IR）与冠脉慢血流（CSF）的相关性及其临床意义。方法 入院行冠状动脉造影（CAG）检查，其冠状动脉狭窄程度<50%的患者110 例，按是否存在CSF，分为2组：慢血流组（n=48)和正常血流组(对照组，n=62)。记录慢血流患者的各主支血管校正的TIMI血流帧幅（CTFC），采用ELISA测定各组患者的血清瘦素（leptin）浓度。采用HOMA模型计数各组患者的胰岛素抵抗指数（HOMA-IR ）。进行单因素和多因素分析其相关性，并采用ROC曲线评价血清瘦素水平、HOMA-IR对CSF的诊断价值。结果 单因素分析中发现瘦素水平、HOMA-IR、年龄、性别、吸烟和血脂等10个指标与CSF有关，多因素分析，只有瘦素和HOMA-IR是CSF的独立相关因素（均P<0.01），血清瘦素水平与MeanTFC(r=0.816,P<0.01)呈正相关；HOMA-IR与meanTFC(r=0.622，P<0.01)呈正相关；血清瘦素水平与HOMA-IR(r=0.484，P<0.01)呈正相关。CSF患者的血清瘦素水平、HOMA-IR的 ROC曲线分析，结果显示，瘦素，IR对CSF的诊断曲线下面积有统计学意义(均P<0.01），曲线下面积分别为 0.972,0.836。结论 血清瘦素和IR与 CSF有相关性，对CSF有一定的诊断价值。
Abstract:
AIM To explore the clinical significance and correlation between serum leptin levels, insulin resistance, and coronary slow flow. METHODS 110 patients with coronary stenosis <50% according to coronary angiography (CAG) were included. They were divided into two groups: CSFP group (n=48) and NCF group (n=62). Coronary artery TIMI frame count of the left anterior descending branch (LAD), the left circumflex branch (LCX), and right coronary artery (RCA) in the CSFP group and NCF group were recorded. The level of fasting serum leptin was examined by enzyme linked immunosorbent assay (ELISA). The insulin resistance index (HOMA-IR) was calculated according to HOMA model (HOMA-IR=FBG×FINS/22.5). The correlation between serum leptin levels, insulin resistance, and coronary slow flow was analyzed. The diagnostic value of serum leptin and HOMA-IR on CSFP was evaluated by receiver operating characteristic (ROC) curve. RESULTS Single factor analysis demonstrated that leptin levels, HOMA-IR, age, gender, smoking and blood lipids, and 4 other indicators were related to CSF. Multivariate analysis revealed that only leptin and HOMA-IR were independent factors associated with CSF. Serum leptin levels were positively correlated with mean TFC (r=0.816, P<0.01); HOMA-IR was positively correlated with mean TFC (r=0.622, P<0.01). Serum leptin levels weree positively correlated with HOMA-IR (r=0.484, P<0.01). The serum leptin level and HOMA-IR ROC curves of CSF patients were analyzed. The results showed that the area under the diagnostic curve of leptin and IR to CSF was statistically significant (P<0.01) and the area under the curve was 0.972, 0.836. CONCLUSION Serum leptin levels and insulin resistance are associated with CSFP, which have certain diagnostic value for CSF.

参考文献/References

[1]Tambe AA,Demany MA,Zimmerman HA,et al.Angian pectoris and slow velocity of dye in coronary arteries-a new angiographic finding[J].Am Heart J,1972,84(1):66-71.

[2]Saya S,Hennebry TA,Lozano P,et al.Coronary slow flow phenomenon and risk for sudden cardiac death due to ventricular arrhythmias:a case report and review of literature[J].Clin Cardiol,2008,31(8):352-355.

[3]Goel PK,Gupta SK,Agarwal A,et al.Slow coronary flow:a distinct angiographic subgroup in syndrome X［J］. Angiology, 2001, 52(8):507-514.

[4]Garg MK, Dutta MK, Mahalle N,et al.Study of beta-cell function by HOMA model) in metabolic syndrome[J].Indian J Endocrinol Metab,2011,15(Supp11):544-549.

[5]Gibson CM,Cannon CP,Daley WL,et al.TIMI frame count:a quantitative method of assessing coronary artery flow[J].Circulation,1996,93(5):879-888.

[6]zhang Y,Proenca R,Maffei M,et al.Positional cloning of the mouse obese gene and its human homologue[J].Nature,1994,372(6505):425-432.

[7]Tahergorabi Z,Khazaei M.Leptin and its cardiovascular effects:Focus on angiogenesis[J].Adv Biomed Res,2015,4:79.

[8]Yamagishi SI,Edelstein D,Du XL,et al.Leptin induces mitochondrial superoxide production and monocyte chemoattractant protein-1 expression in aortic endothelial cells by incresing fatty acid oxidation via protein kinase A[J].J Biol Chem,2001,276(27):25096-25100.

[9]Ravanat JL,Cadet J,Douki T,Oxidatively generated DNA lesions as potential biomarkers of in vivo oxidative stress[J].Curr Mol Med,2012,12(6):655-671.

[10]Mehebik-Mojaat N,Ribiere C,Niang F,et al.Leptin and insulin induce mutual resistance for nitric oxide synthase III activation in adipocytes[J].J Cell Biochem,2009,108(4):982-988.

[11]曹荟哲,哈小琴,李雪雁,等.游离脂肪酸致胰岛素抵抗的分子机制[J].解放军医学杂志,2017,42(1):81-85.

[12]Kol E,Speakm an JR,Regulation of body mass and adiposity in the field vole Microtus agrest is a model of leptin resistance[J].J Endocrinol,2007,192(2):271-278.

备注/Memo

备注/Memo:
收稿日期：2017-09-14.通讯作者：楚天舒，主任医师，主要从事冠心病研究 Email：Chutianshu2014@163.com 作者简介：武力勇，主治医师，硕士 Email：645485129@qq.com
更新日期/Last Update: 1900-01-01