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冠心病和心力衰竭中的抵抗素水平:肾功能的核心作用。

Resistin level in coronary artery disease and heart failure: the central role of kidney function.

机构信息

Department of Critical Care Medicine and Surgery, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, Florence, Italy.

出版信息

J Cardiovasc Med (Hagerstown). 2013 Feb;14(2):150-7. doi: 10.2459/JCM.0b013e32834eec93.

Abstract

OBJECTIVES

The aim of this study was to evaluate resistin levels in patients with coronary artery disease (CAD) with or without chronic heart failure, in order to define its independent predictor.

METHODS

One hundred and seven outpatients with CAD were enrolled in the study and divided into three groups: CAD without left-ventricular systolic dysfunction (group 1); CAD with left-ventricular dysfunction without heart failure symptoms (group 2); CAD with overt heart failure (group 3). Plasma resistin was determined by ELISA.

RESULTS

Resistin progressively increased from group 1 (10.7±5.0 ng/ml) to groups 2 (11.8±5.8 ng/ml) and 3 (17.0±6.8 ng/ml), with the difference reaching statistical significance in group 3 versus groups 1 and 2 (P=0.001). A multivariable model of analysis demonstrated that the best predictor of plasma resistin level was the estimated glomerular filtration rate (P<0.001), indicating that reduction of kidney function was the main cause of the adipokine increase observed in patients with CAD and overt heart failure.

CONCLUSIONS

Our data confirm the rise of resistin plasma levels previously described in patients affected by chronic heart failure; however, in our study, this relationship seemed to be mediated mainly by the level of kidney function, and only partially by the severity of ventricular dysfunction.

摘要

目的

本研究旨在评估冠心病(CAD)合并或不合并慢性心力衰竭患者的抵抗素水平,以确定其独立预测因子。

方法

纳入 107 例 CAD 门诊患者,并将其分为三组:无左心室收缩功能障碍的 CAD(组 1);有左心室功能障碍但无心力衰竭症状的 CAD(组 2);有明显心力衰竭的 CAD(组 3)。通过 ELISA 法测定血浆抵抗素水平。

结果

抵抗素水平逐渐从组 1(10.7±5.0 ng/ml)升高到组 2(11.8±5.8 ng/ml)和组 3(17.0±6.8 ng/ml),组 3与组 1和组 2相比差异有统计学意义(P=0.001)。多变量分析模型表明,血浆抵抗素水平的最佳预测因子是估计肾小球滤过率(P<0.001),表明肾功能的降低是 CAD 和明显心力衰竭患者观察到的脂肪因子增加的主要原因。

结论

我们的数据证实了先前在慢性心力衰竭患者中描述的抵抗素血浆水平的升高;然而,在我们的研究中,这种关系似乎主要是由肾功能水平介导的,而仅仅部分是由心室功能障碍的严重程度介导的。

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