Zhang Zhixin, Wang Lin, Zhan Yu, Xie Cui, Xiang Yang, Chen Dan, Wu You
Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China.
BMC Cardiovasc Disord. 2022 May 12;22(1):215. doi: 10.1186/s12872-022-02554-4.
This study aimed to explore clinical value and expression of Homer 1, S-adenosyl-l-homocysteine (SAH), homocysteine (Hcy), fibroblast growth factors (FGF) 23 in coronary heart disease (CHD).
From March 2020 to April 2021, a total of 137 patients with CHD and 138 healthy subjects who came to our hospital for physical examination and had no cardiovascular disease were retrospectively enrolled, and they were assigned to the CHD group and the control group, respectively. Patients in the CHD group were divided into stable angina pectoris (SAP) group (n = 48), unstable angina pectoris (UAP) group (n = 46), and acute myocardial infarction (AMI) group (n = 43) according to clinical characteristics for subgroup analysis. The degree of coronary artery stenosis was assessed by Gensini score, which is a reliable assessment tool for the severity of coronary artery disease. The levels of Homer 1, SAH, Hcy, and FGF 23 were tested and compared. Spearman correlation analysis was used to analyze the correlation between serum Homer1, SAH, Hcy, FGF23 levels and Gensini score, and multivariate unconditional Logistic regression was used to analyze the risk factors of coronary heart disease.
Demographic characteristics of each group were comparable (P > 0.05). The body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and glucose levels of the SAP group, UAP group and AMI group were significantly higher than those of the control group, and the number of patients with smoking, alcohol consumption, hypertension, and diabetes history was significantly more than that of the control group, respectively (P < 0.05). The level of high-density lipoprotein cholesterol (HDL-C) of each subgroup was significantly lower than the control group (P < 0.05). The above indicators showed no significant difference among three subgroups (P > 0.05). Serum SAH, Hcy, Homer1 and FGF23 levels in each subgroup were significantly higher than those in control group (P < 0.05). And above indicators in SAP group and UAP group were significantly lower than those in AMI group (P < 0.05), and the levels of above indicators in SAP group were significantly lower than those in UAP group (P < 0.05). The results of Spearman correlation analysis showed that serum Homer1, FGF23, SAH, Hcy levels were positively correlated with Gensini score (r = 0.376, 0.623, 0.291, 0.372, all P < 0.01). Multivariate logistic regression analysis showed that smoking, hypertension, diabetes, alcohol consumption, obesity, HDL-C, FGF23, SAH, Hcy, Homer 1 were independent risk factors for coronary heart disease.
The levels of FGF23, SAH, Hcy, and Homer1 tend to increase in patients with CHD compared with normal population, and the more severe the disease, the higher the levels, which has certain reference value for the clinical diagnosis of CHD and the evaluation and monitoring of the disease.
本研究旨在探讨荷马1（Homer 1）、S-腺苷-L-高半胱氨酸（SAH）、高半胱氨酸（Hcy）、成纤维细胞生长因子（FGF）23在冠心病（CHD）中的临床价值及表达情况。
回顾性纳入2020年3月至2021年4月期间来我院体检且无心血管疾病的137例冠心病患者和138例健康受试者，分别分为冠心病组和对照组。冠心病组患者根据临床特征分为稳定型心绞痛（SAP）组（n = 48）、不稳定型心绞痛（UAP）组（n = 46）和急性心肌梗死（AMI）组（n = 43）进行亚组分析。采用Gensini评分评估冠状动脉狭窄程度，这是一种评估冠状动脉疾病严重程度的可靠工具。检测并比较Homer 1、SAH、Hcy和FGF 23的水平。采用Spearman相关性分析血清Homer1、SAH、Hcy、FGF23水平与Gensini评分的相关性，采用多因素非条件Logistic回归分析冠心病的危险因素。
各组的人口统计学特征具有可比性（P > 0.05）。SAP组、UAP组和AMI组的体重指数（BMI）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）和血糖水平均显著高于对照组，吸烟、饮酒、高血压和糖尿病史患者人数分别显著多于对照组（P < 0.05）。各亚组的高密度脂蛋白胆固醇（HDL-C）水平均显著低于对照组（P < 0.05）。上述指标在三个亚组之间无显著差异（P > 0.05）。各亚组血清SAH、Hcy、Homer1和FGF23水平均显著高于对照组（P < 0.05）。上述指标在SAP组和UAP组显著低于AMI组（P < 0.05），且在SAP组显著低于UAP组（P < 0.05）。Spearman相关性分析结果显示，血清Homer1、FGF23、SAH、Hcy水平与Gensini评分呈正相关（r = 0.376、0.623、0.291、0.372，均P < 0.01）。多因素Logistic回归分析显示，吸烟、高血压、糖尿病、饮酒、肥胖、HDL-C、FGF23、SAH、Hcy、Homer 1是冠心病的独立危险因素。
与正常人群相比，冠心病患者FGF23、SAH、Hcy和Homer1水平有升高趋势，且病情越严重，水平越高，这对冠心病的临床诊断及病情评估和监测具有一定的参考价值。
