Laurikka Antti, Vuolteenaho Katriina, Toikkanen Vesa, Rinne Timo, Leppänen Tiina, Tarkka Matti, Laurikka Jari, Moilanen Eeva
The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland.
Eur J Cardiothorac Surg. 2014 Oct;46(4):729-36. doi: 10.1093/ejcts/ezt634. Epub 2014 Jan 30.
Adipocytokines are hormones regulating energy metabolism and appetite and according to recent reports also inflammatory responses including ischaemia-reperfusion injury. Based on experimental data, we hypothesized that the levels of adipocytokines adiponectin, adipsin, leptin and/or resistin would correlate with myocardial injury, inflammation and oxidative stress during cardiac surgery.
Thirty-two patients undergoing an elective on-pump coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB) were recruited into the study. Blood samples were collected after the induction of anaesthesia, and at the onset of CPB, 1 and 15 min after the removal of aortic cross-clamp and 4 and 24 h after the onset of CPB. Samples were analysed for levels of four adipocytokines (adiponectin, adipsin, leptin and resistin) and markers of oxidative stress [myeloperoxidase (MPO) and 8-isoprostane], inflammation [interleukin-6 (IL-6)] and myocardial injury [troponin T (TnT)].
Adiponectin and adipsin concentrations declined, while leptin and resistin levels increased significantly by 24 h after the onset of the operation. Interestingly, basal levels of resistin (r = 0.41, P = 0.020) as well as the maximal increase occurring in resistin levels during the 24-h follow-up (r = 0.49, P = 0.005) correlated positively with TnT release. In addition, the reperfusion-induced elevation in resistin levels correlated positively with oxidative stress measured as increases in MPO concentrations.
As an original finding, we report here that resistin levels correlate with oxidative stress and myocardial injury in patients undergoing cardiac surgery. In addition, leptin levels were increased on the first postoperative day, but only minor declines were found in adiponectin and adipsin levels. Resistin has been implicated in unfavourable metabolic, cardiovascular and inflammatory responses: it may thus serve as a useful biomarker or a drug target in conditions complicated by ischaemia-reperfusion injury.
脂肪细胞因子是调节能量代谢和食欲的激素，根据最近的报道，它们还参与包括缺血再灌注损伤在内的炎症反应。基于实验数据，我们推测脂肪细胞因子脂联素、脂肪酶、瘦素和/或抵抗素的水平与心脏手术期间的心肌损伤、炎症和氧化应激相关。
32例行择期体外循环冠状动脉搭桥术（CABG）的患者被纳入本研究。在麻醉诱导后、体外循环开始时、主动脉阻断钳移除后1和15分钟以及体外循环开始后4和24小时采集血样。分析样本中四种脂肪细胞因子（脂联素、脂肪酶、瘦素和抵抗素）的水平以及氧化应激标志物[髓过氧化物酶（MPO）和8-异前列腺素]、炎症标志物[白细胞介素-6（IL-6）]和心肌损伤标志物[肌钙蛋白T（TnT）]。
脂联素和脂肪酶浓度下降，而瘦素和抵抗素水平在手术开始后24小时显著升高。有趣的是，抵抗素的基础水平（r = 0.41，P = 0.020）以及随访24小时期间抵抗素水平的最大升高幅度（r = 0.49，P = 0.005）与TnT释放呈正相关。此外，再灌注诱导的抵抗素水平升高与以MPO浓度升高衡量的氧化应激呈正相关。
作为一项原创性发现，我们在此报告，抵抗素水平与心脏手术患者的氧化应激和心肌损伤相关。此外，术后第一天瘦素水平升高，但脂联素和脂肪酶水平仅略有下降。抵抗素与不良的代谢、心血管和炎症反应有关：因此，在伴有缺血再灌注损伤的情况下，它可能作为一种有用的生物标志物或药物靶点。
