Khafaji Hadi A R Hadi, Bener Abdul Bari, Rizk Nasser M, Al Suwaidi Jassim
Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
BMC Res Notes. 2012 May 29;5:262. doi: 10.1186/1756-0500-5-262.
To assess the relationship between serial serum leptin levels in patients with acute myocardial infarction (AMI) who received thrombolysis and the degree of coronary atherosclerosis, coronary reperfusion, echocardiographic findings, and clinical outcome. 51 consecutive patients presenting with AMI were studied. Clinical characteristics including age, sex, body mass index (BMI) and cardiovascular risk factors were recorded. Serial serum leptin levels at the time of admission and subsequently at 0, 6, 12, 24, 36, 60 hours afterwards were obtained. Coronary angiography was performed in 34 patients; the relation between serum leptin levels and evidence of coronary reperfusion as well as the extent of coronary atherosclerosis according to the coronary artery surgery study classification (CASS) were evaluated. Echocardiographic evaluation was performed in all patients. 36 matched patients were enrolled as control group who had serum leptin level 9.4 ± 6.5 ng/ml.
The patients mean age was 50.5 ± 10.6 years. There were 47 males and 3 females. 37.1% were diabetics, 23.5% were hypertensive, 21.6% were dyslipidemic and 22.7% were obese (BMI ≥ 30). Leptin concentrations (ng/ml) increased and peaked at the 4th sample (36 hrs) after admission (mean ± SD) sample (1) =9.55 ± 7.4, sample (2) =12.9 ± 8.4, sample (3) =13.8 ± 10.4, sample (4) =18.9 ± 18.1, sample (5) =11.4 ± 6.5, sample (6) =10.8 ± 8.9 ng/ml. There was a significant correlation between serum leptin and BMI (r = 0.342; p = 0.03). Leptin levels correlated significantly to creatine kinase level on the second day (r = 0.43, p ≤ 0.01). Significant correlation of mean serum leptin with the ejection fraction (P < 0.05) was found. No difference in timing of peak serum leptin between patients who achieved coronary reperfusion vs. those who did not (p = 0.8). There was a trend for an increase in the mean serum leptin levels with increasing number of diseased vessels. There was no correlation between serum leptin levels and outcome neither during the hospitalization nor at 9 months follow up.
Serum leptin levels increase after myocardial infarction. Serum leptin level may be a predictor of the left ventricular ejection fraction and the degree of atherosclerosis but not of coronary reperfusion.
评估接受溶栓治疗的急性心肌梗死（AMI）患者血清瘦素水平的变化与冠状动脉粥样硬化程度、冠状动脉再灌注、超声心动图检查结果及临床结局之间的关系。对51例连续就诊的AMI患者进行了研究。记录了患者的年龄、性别、体重指数（BMI）及心血管危险因素等临床特征。测定了患者入院时及随后0、6、12、24、36、60小时的系列血清瘦素水平。对34例患者进行了冠状动脉造影；评估了血清瘦素水平与冠状动脉再灌注证据以及根据冠状动脉外科研究分类（CASS）的冠状动脉粥样硬化程度之间的关系。对所有患者进行了超声心动图评估。选取36例血清瘦素水平为9.4±6.5 ng/ml的匹配患者作为对照组。
患者的平均年龄为50.5±10.6岁。其中男性47例，女性3例。37.1%的患者患有糖尿病，23.5%患有高血压，21.6%血脂异常，22.7%肥胖（BMI≥30）。瘦素浓度（ng/ml）在入院后的第4个样本（36小时）时升高并达到峰值（均值±标准差）：样本（1）=9.55±7.4，样本（2）=12.9±8.4，样本（3）=13.8±10.4，样本（4）=18.9±18.1，样本（5）=11.4±6.5，样本（6）=10.8±8.9 ng/ml。血清瘦素与BMI之间存在显著相关性（r = 0.342；p = 0.03）。瘦素水平与第二天的肌酸激酶水平显著相关（r = 0.43，p≤0.01）。发现平均血清瘦素与射血分数之间存在显著相关性（P < 0.05）。实现冠状动脉再灌注的患者与未实现再灌注的患者之间血清瘦素峰值出现时间无差异（p = 0.8）。随着病变血管数量的增加，平均血清瘦素水平有升高趋势。血清瘦素水平与住院期间及9个月随访时的结局均无相关性。
心肌梗死后血清瘦素水平升高。血清瘦素水平可能是左心室射血分数和动脉粥样硬化程度的预测指标，但不是冠状动脉再灌注的预测指标。
