Department of Cardiology, Mamatsio General Hospital, Kozani, Greece.
Transl Res. 2010 May;155(5):238-46. doi: 10.1016/j.trsl.2010.01.004. Epub 2010 Feb 21.
Apelin and ghrelin have emerged as novel adipokines, but their role in coronary artery disease (CAD) remains obscure. In the present study, we analyzed their serum levels in patients with acute coronary syndromes (ACS) or established asymptomatic CAD. A total of 355 participants were enrolled. Among them were 80 patients with unstable angina (UA) and 115 patients with acute myocardial infarction (AMI) hospitalized in the coronary care unit. We also included 88 asymptomatic patients with established CAD (asymptomatic CAD) and 72 age-and sex-matched healthy controls (HCs). All groups with CAD underwent coronary angiography, and the Gensini score was determined. Clinical parameters, glycemic and lipid profile, high-sensitivity CRP (hsCRP), insulin resistance (HOMA-IR), as well as apelin and ghrelin were assayed. Patients with ACS (UA or AMI) were sampled at hospital admission. All 3 groups with CAD (UA, AMI, or asymptomatic CAD) showed significantly higher levels of hsCRP, HOMA-IR, and white blood cells than controls (P < 0.01). Conversely, apelin and ghrelin concentrations were considerably (P < 0.05) lower in CAD patients with respect to the control group. Most importantly, UA (6.72 +/- 3.51 ng/mL) and AMI (6.02 +/- 4.07 ng/mL) groups had even lower apelin levels on admission compared with the asymptomatic CAD group (13.53 +/- 5.2 ng/mL) (P < 0.05). Logistic regression analysis showed an independent association of low apelin and ghrelin levels with CAD presence. Besides this result, apelin showed an inverse relationship with ACS incidence and a Gensini score independent of other cardiovascular risk factors (P < 0.05). In conclusion, CAD seemed to correlate with low serum apelin and ghrelin levels. Moreover, apelin concentrations inversely were associated with the severity and the acute phase of CAD, which suggests its involvement in the progression and destabilization of coronary atherosclerotic plaques.
Apelin 和 ghrelin 已成为新的脂肪因子，但它们在冠状动脉疾病 (CAD) 中的作用仍不清楚。在本研究中，我们分析了急性冠状动脉综合征 (ACS) 或已确诊无症状 CAD 患者的血清水平。共有 355 名参与者入组。其中 80 例不稳定型心绞痛 (UA) 患者和 115 例急性心肌梗死 (AMI) 患者入住冠心病监护病房。我们还包括 88 例无症状已确诊 CAD（无症状 CAD）患者和 72 名年龄和性别匹配的健康对照者 (HCs)。所有 CAD 患者均接受冠状动脉造影，并确定 Gensini 评分。测定临床参数、血糖和血脂谱、高敏 C 反应蛋白 (hsCRP)、胰岛素抵抗 (HOMA-IR) 以及 apelin 和 ghrelin。ACS（UA 或 AMI）患者在入院时采样。所有 CAD 组（UA、AMI 或无症状 CAD）的 hsCRP、HOMA-IR 和白细胞计数均明显高于对照组 (P < 0.01)。相反，与对照组相比，CAD 患者的 apelin 和 ghrelin 浓度显著降低 (P < 0.05)。最重要的是，UA（6.72 +/- 3.51ng/mL）和 AMI（6.02 +/- 4.07ng/mL）组入院时的 apelin 水平甚至低于无症状 CAD 组（13.53 +/- 5.2ng/mL）(P < 0.05)。Logistic 回归分析显示，低 apelin 和 ghrelin 水平与 CAD 存在独立相关。除了这一结果，apelin 与 ACS 发生率呈负相关，与其他心血管危险因素无关，与 CAD 的严重程度和急性期呈独立关系 (P < 0.05)。总之，CAD 似乎与血清 apelin 和 ghrelin 水平降低有关。此外，apelin 浓度与 CAD 的严重程度和急性期呈负相关，提示其参与冠状动脉粥样硬化斑块的进展和不稳定。
