Narumi Taro, Watanabe Tetsu, Kadowaki Shinpei, Kinoshita Daisuke, Yokoyama Miyuki, Honda Yuki, Otaki Yoichiro, Nishiyama Satoshi, Takahashi Hiroki, Arimoto Takanori, Shishido Tetsuro, Miyamoto Takuya, Kubota Isao
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan.
Cardiovasc Diabetol. 2014 Apr 23;13:84. doi: 10.1186/1475-2840-13-84.
Various adipokines are reported to be associated with the development of heart failure (HF) through insulin resistance and chronic inflammation. Omentin-1 is a novel adipokine and is associated with incident coronary artery disease. However, it remains unclear whether serum omentin-1 levels are associated with cardiac prognosis in patients with HF.
We measured serum omentin-1 levels at admission in 136 consecutive patients with HF, and 20 control subjects without signs of significant heart disease. We prospectively followed patients with HF to endpoints of cardiac death or re-hospitalization for worsening HF.
Serum omentin-1 levels were markedly lower in HF patients with cardiac events compared with to without. The patients who were in New York Heart Association (NYHA) functional class IV showed significantly lower serum omentin-1 levels compared to those in class II and III, whereas serum omentin-1 levels did not correlate with serum brain natriuretic peptide levels (r = 0.217, P = 0.011). We divided the HF patients into three groups based on the tertiles of serum omentin-1 level (low T1, middle T2, and high T3). Multivariate Cox hazard analysis showed that the lowest serum omentin-1 level (T1) was independently associated with cardiac events after adjustment for confounding factors (hazard ratio 5.78, 95% confidence interval 1.20-12.79). We divided the HF patients into two groups according to the median serum omentin-1 levels. Kaplan-Meier analysis revealed that the patients with low serum omentin-1 levels had a higher risk of cardiac events compared with those with high serum omentin-1 levels (log-rank test p < 0.001).
Decreased serum omentin-1 levels were associated with a poor cardiac outcome in patients with HF.
据报道，多种脂肪因子通过胰岛素抵抗和慢性炎症与心力衰竭（HF）的发生发展相关。网膜素-1是一种新型脂肪因子，与冠心病的发生有关。然而，血清网膜素-1水平是否与HF患者的心脏预后相关仍不清楚。
我们测量了136例连续入院的HF患者以及20例无明显心脏病迹象的对照者入院时的血清网膜素-1水平。我们对HF患者进行前瞻性随访，直至出现心脏死亡或因HF恶化再次住院的终点事件。
发生心脏事件的HF患者血清网膜素-1水平明显低于未发生心脏事件的患者。纽约心脏协会（NYHA）心功能IV级的患者血清网膜素-1水平明显低于II级和III级患者，而血清网膜素-1水平与血清脑钠肽水平无相关性（r = 0.217，P = 0.011）。我们根据血清网膜素-1水平的三分位数将HF患者分为三组（低水平T1、中等水平T2和高水平T3）。多因素Cox风险分析显示，在调整混杂因素后，最低血清网膜素-1水平（T1）与心脏事件独立相关（风险比5.78，95%置信区间1.20 - 12.79）。我们根据血清网膜素-1水平的中位数将HF患者分为两组。Kaplan-Meier分析显示，血清网膜素-1水平低的患者发生心脏事件的风险高于血清网膜素-1水平高的患者（对数秩检验p < 0.001）。
血清网膜素-1水平降低与HF患者不良的心脏结局相关。
