Ji Yanjing, Du Shiyu, Tang Chao, Song Jinyou, Gu Xiaosong
Department of Cardiology, No. 904 Hospital of Joint Logistics Support Force of PLA, 214000 Wuxi, Jiangsu, China.
Department of Cardiology, the second affiliated hospital of Soochow University, 215000 Suzhou, Jiangsu, China.
Rev Cardiovasc Med. 2023 Jan 31;24(2):33. doi: 10.31083/j.rcm2402033. eCollection 2023 Feb.
Existing research has shown that retinol binding protein (RBP4) has an impairing effect on arterial elasticity and induces insulin resistance, but the clinical value of RBP4 in patients with coronary heart disease (CHD) combined with type 2 diabetes mellitus (T2DM) has not been investigated. This study sought to compare the complexity of coronary artery lesions and coronary artery elasticity between patients with CHD combined with T2DM and those with CHD without T2DM, analyze the risk factors affecting coronary artery elasticity, and investigate the value of RBP4 in assessing coronary artery elasticity in patients with CHD and T2DM.
A total of 130 patients with confirmed CHD were consecutively enrolled, including 38 patients with CHD combined with T2DM and 92 patients with CHD without T2DM. Basic clinical data, laboratory findings, coronary angiography and intravascular ultrasound (IVUS) imaging data, and Gensini scores and coronary artery elasticity parameters were calculated in both groups. Elasticity parameters included: stiffness parameter ( ), pressure-strain elastic modulus ( ), distensibility coefficient (DC), and compliance coefficient (CC). Multiple linear regression equations were established with elasticity parameters as dependent variables to explore the factors influencing coronary artery elasticity parameters in patients within the two groups.
Compared with patients in the CHD without T2DM group, patients in the CHD combined with T2DM group had higher RBP4 levels, Gensini scores, and values, and lower DC and CC values. Linear regression analysis showed that Gensini score increased with higher and values and decreased with higher DC and CC values. In all patients in the CHD and CHD combined with T2DM groups, RBP4 was an independent risk factor for values after correction for confounders by multiple linear regression analysis, whereas in patients in the CHD without T2DM group, the effect of RBP4 on values was not statistically different.
RBP4 was an independent risk factor of coronary artery elasticity in CHD patients with T2DM and in overall CHD patients, but it did not affect coronary artery elasticity in CHD patients without T2DM.
现有研究表明,视黄醇结合蛋白(RBP4)对动脉弹性有损害作用并诱导胰岛素抵抗,但RBP4在冠心病(CHD)合并2型糖尿病(T2DM)患者中的临床价值尚未得到研究。本研究旨在比较CHD合并T2DM患者与无T2DM的CHD患者之间冠状动脉病变的复杂性和冠状动脉弹性,分析影响冠状动脉弹性的危险因素,并探讨RBP4在评估CHD和T2DM患者冠状动脉弹性中的价值。
连续纳入130例确诊为CHD的患者,其中CHD合并T2DM患者38例,无T2DM的CHD患者92例。计算两组患者的基本临床资料、实验室检查结果、冠状动脉造影和血管内超声(IVUS)成像数据,以及Gensini评分和冠状动脉弹性参数。弹性参数包括:硬度参数( )、压力应变弹性模量( )、扩张系数(DC)和顺应系数(CC)。以弹性参数为因变量建立多元线性回归方程,探讨两组患者中影响冠状动脉弹性参数的因素。
与无T2DM的CHD组患者相比,CHD合并T2DM组患者的RBP4水平、Gensini评分、 和 值更高,而DC和CC值更低。线性回归分析显示,Gensini评分随 和 值升高而增加,随DC和CC值升高而降低。在CHD组和CHD合并T2DM组的所有患者中,经多元线性回归分析校正混杂因素后,RBP4是 值的独立危险因素,而在无T2DM的CHD组患者中,RBP4对 值的影响无统计学差异。
RBP4是T2DM的CHD患者和总体CHD患者冠状动脉弹性的独立危险因素,但对无T2DM的CHD患者的冠状动脉弹性无影响。