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瘦素、脂联素、肿瘤坏死因子-α 和鸢尾素浓度作为肥胖与心血管疾病住院患者心房颤动风险相关的因素。

Leptin, adiponectin, tumor necrosis factor α, and irisin concentrations as factors linking obesity with the risk of atrial fibrillation among inpatients with cardiovascular diseases.

机构信息

Department of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland

Department of Allergology, Clinical Immunology and Internal Diseases, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland

出版信息

Kardiol Pol. 2019 Nov 22;77(11):1055-1061. doi: 10.33963/KP.14989. Epub 2019 Sep 25.

Abstract

BACKGROUND

The endocrine function of adipose tissue and skeletal muscles mediates the risk of cardiovascular complications of obesity.

AIMS

The aim of this study was to determine the associations of leptin, adiponectin (ADA), tumor necrosis factor α (TNF‑α), and irisin levels with the diagnosis of atrial fibrillation (AF) on admission to the hospital as well as parameters of transthoracic echocardiography among inpatients with cardiovascular diseases (CVDs).

METHODS

The study included 80 consecutive patients hospitalized due to paroxysmal or persistent AF and a control group of 165 age- and sex‑matched individuals admitted due to exacerbation of chronic CVD. In all participants, we assessed serum leptin, ADA, TNF‑α, and irisin concentrations, body composition determined by bioelectrical impedance analysis, and transthoracic echocardiographic parameters.

RESULTS

Compared with controls, patients with AF had greater fat mass (FM), higher serum leptin levels and lower levels of ADA, TNF‑α, and irisin when indexed to body surface area, FM, and visceral adiposity. Hyperleptinemia slightly increased the risk of AF (odds ratio [OR], 1.02; 95% CI, 1.01-1.03; P <0.01). The correlation was stronger after indexation to FM (OR, 1.34; 95% CI, 1.01-1.81; P <0.05). The coefficients of significant correlations with echocardiographic parameters were stronger for irisin than for adipocytokines: 0.16 to 0.35 and 0.12 to 0.22, respectively.

CONCLUSIONS

Adipocytokines and irisin exert a significant but weak effect on heart chamber size and affect the risk of AF occurrence. Their blood concentrations do not seem to be related simply to body composition but probably depend on individual variations in adipocytokine and myokine secretion as a result of numerous factors.

摘要

背景

脂肪组织和骨骼肌的内分泌功能介导肥胖引起的心血管并发症的风险。

目的

本研究旨在确定入院时血清瘦素、脂联素(ADA)、肿瘤坏死因子-α(TNF-α)和鸢尾素水平与心房颤动(AF)诊断的相关性,以及这些因子与心血管疾病(CVDs)住院患者经胸超声心动图参数的相关性。

方法

本研究纳入了 80 例因阵发性或持续性 AF 入院的连续患者和 165 例因慢性 CVD 加重入院的年龄和性别匹配的对照组。在所有参与者中,我们评估了血清瘦素、ADA、TNF-α 和鸢尾素浓度、生物电阻抗分析确定的身体成分以及经胸超声心动图参数。

结果

与对照组相比,AF 患者的脂肪量(FM)更大,血清瘦素水平更高,ADA、TNF-α 和鸢尾素水平更低,当按体表面积、FM 和内脏脂肪指数校正时。高瘦素血症略微增加了 AF 的风险(比值比[OR],1.02;95%置信区间,1.01-1.03;P<0.01)。按 FM 校正后相关性更强(OR,1.34;95%置信区间,1.01-1.81;P<0.05)。与超声心动图参数有显著相关性的系数对于鸢尾素比对于脂肪细胞因子更强:分别为 0.16 至 0.35 和 0.12 至 0.22。

结论

脂肪细胞因子和鸢尾素对心腔大小有显著但微弱的影响,并影响 AF 发生的风险。它们的血液浓度似乎与身体成分无关,而可能取决于脂肪细胞因子和肌细胞因子分泌的个体差异,这是由众多因素引起的。

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