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循环神经调节蛋白 4 和鸢尾素与传统和新型心血管代谢危险因素与冠心病风险和严重程度的关系。

The relationship of circulating neuregulin 4 and irisin, and traditional and novel cardiometabolic risk factors with the risk and severity of coronary artery disease.

机构信息

Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Cytokine. 2023 Oct;170:156314. doi: 10.1016/j.cyto.2023.156314. Epub 2023 Aug 15.

Abstract

BACKGROUND AND AIMS

Neuregulin 4 (NRG4) and irisin are adipokines that have been suggested to be associated with cardiometabolic risk factors and coronary artery disease (CAD), but the data are inconclusive. This study aimed to investigate the relationship between circulating NRG4 and irisin and cardiometabolic risk factors with CAD risk and severity.

METHODS AND RESULTS

In this cross-sectional study, the presence of CAD and the severity of stenosis (gensini score) were documented based on coronary angiography in 166 adults. Circulating NRG4 and irisin, glucose homeostasis markers, hs-CRP, lipid profiles, blood pressure, and anthropometric measurements were assessed as well. Age (p = 0.005), sex (p = 0.008), SBP (p = 0.033), DBP (p = 0.04), MAP (p = 0.018), FBG (p = 0.012), insulin (p = 0.039) and HOMA-IR (p = 0.01) were significantly associated with odds of having CAD. The final logistic regression model showed that age, sex, HOMA-IR, and MAP were the most important determinants of having CAD. There were no significant associations between circulating irisin and NRG4 with odds of having CAD. The final general linear model showed that being men (β = 17.303, 95% CI: 7.086-27.52, P = 0.001), age (Aβ = 0.712, 95% CI: 0.21-1.214, P = 0.006), HOMA-IR (Aβ = 2.168, 95% CI: 0.256 to 4.079, P = 0.027), and NRG4 level (β = 1.836, 95% CI: 0.119-3.553, P = 0.036) were directly associated with higher gensini score. Participants with the three-vessel disease had a mean increase of about 5 units in circulating irisin compared to those with no clinical CAD (β = 5.221, 95% CI: 0.454-9.987, p = 0.032).

CONCLUSIONS

This study showed that the adipokines NRG4 and Irisin might be associated with the severity of coronary stenosis.

摘要

背景与目的

神经调节蛋白 4(NRG4)和鸢尾素是两种脂肪因子,它们与心血管代谢危险因素和冠心病(CAD)有关,但数据尚无定论。本研究旨在探讨循环 NRG4 和鸢尾素与 CAD 风险和严重程度的关系,以及与心血管代谢危险因素的关系。

方法与结果

在这项横断面研究中,根据冠状动脉造影记录了 166 名成年人的 CAD 存在情况和狭窄严重程度(Gensini 评分)。还评估了循环 NRG4 和鸢尾素、葡萄糖稳态标志物、hs-CRP、血脂谱、血压和人体测量学指标。年龄(p=0.005)、性别(p=0.008)、SBP(p=0.033)、DBP(p=0.04)、MAP(p=0.018)、FBG(p=0.012)、胰岛素(p=0.039)和 HOMA-IR(p=0.01)与 CAD 的发生几率显著相关。最终的逻辑回归模型显示,年龄、性别、HOMA-IR 和 MAP 是 CAD 发生的最重要决定因素。循环鸢尾素和 NRG4 与 CAD 的发生几率之间没有显著关联。最终的一般线性模型显示,男性(β=17.303,95%CI:7.086-27.52,P=0.001)、年龄(β=0.712,95%CI:0.21-1.214,P=0.006)、HOMA-IR(β=2.168,95%CI:0.256-4.079,P=0.027)和 NRG4 水平(β=1.836,95%CI:0.119-3.553,P=0.036)与更高的 Gensini 评分直接相关。与无临床 CAD 的患者相比,三血管病变患者的循环鸢尾素水平平均增加约 5 个单位(β=5.221,95%CI:0.454-9.987,p=0.032)。

结论

本研究表明,脂肪因子 NRG4 和鸢尾素可能与冠状动脉狭窄的严重程度有关。

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