Takeishi Yasuchika, Niizeki Takeshi, Arimoto Takanori, Nozaki Naoki, Hirono Osamu, Nitobe Joji, Watanabe Tetsu, Takabatake Noriaki, Kubota Isao
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine.
Circ J. 2007 Apr;71(4):460-4. doi: 10.1253/circj.71.460.
Resistin is derived from fat tissue in rodents, and serum levels are elevated in animal models of obesity and insulin resistance. Recent studies have reported that resistin is correlated with markers of inflammation and oxidative stress and is predictive of coronary atherosclerosis in humans. However, clinical significance of serum resistin has not been examined in heart failure. Therefore, the purpose of this study was to examine whether: (1) resistin is correlated with the severity of heart failure; and (2) resistin can predict clinical outcomes of patients with heart failure.
Serum levels of resistin in 126 patients hospitalized for heart failure and 18 control subjects were measured. The patients were followed up with end-points of cardiac death and re-hospitalization caused by worsening of heart failure. The serum resistin level was higher in patients with heart failure than in control subjects and increased with advancing New York Heart Association functional class. The normal upper limit of the resistin level was determined as the mean +2 standard deviation value of control subjects (14.1 ng/ml). In heart failure patients, the cardiac event rate was higher in patients with a high resistin level than in those with a normal level. Among age, body mass index, serum levels of resistin, brain natriuretic peptide, loop diuretics selected by the univariate Cox regression hazard analysis, age and resistin were significant predictors of future cardiac events by multivariate Cox analysis.
Serum resistin was related to the severity of heart failure and associated with a high risk for adverse cardiac events in patients with heart failure.
抵抗素由啮齿动物的脂肪组织产生,在肥胖和胰岛素抵抗动物模型中血清水平升高。最近的研究报道,抵抗素与炎症和氧化应激标志物相关,并且可预测人类冠状动脉粥样硬化。然而,血清抵抗素在心力衰竭中的临床意义尚未得到研究。因此,本研究的目的是探讨:(1)抵抗素是否与心力衰竭的严重程度相关;(2)抵抗素能否预测心力衰竭患者的临床结局。
测定了126例因心力衰竭住院的患者和18例对照者的血清抵抗素水平。对患者进行随访,以心脏死亡和因心力衰竭恶化导致再次住院作为终点事件。心力衰竭患者的血清抵抗素水平高于对照者,且随着纽约心脏协会功能分级的升高而增加。抵抗素水平的正常上限确定为对照者的均值+2标准差(14.1 ng/ml)。在心力衰竭患者中,抵抗素水平高的患者心脏事件发生率高于水平正常者。在年龄、体重指数、血清抵抗素水平、脑钠肽、袢利尿剂中,经单因素Cox回归风险分析筛选后,年龄和抵抗素经多因素Cox分析是未来心脏事件的显著预测因素。
血清抵抗素与心力衰竭的严重程度相关,并且与心力衰竭患者发生不良心脏事件的高风险相关。