Wang Xinchen, Bu Haiwei, Wei Chen, Liu Jingyi, Qi Yuewen, Shan Weichao, Zhang Ying, Sun Lixian
Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, People's Republic of China.
The Cardiovascular Research Institute of Chengde, Chengde, People's Republic of China.
J Inflamm Res. 2024 Oct 2;17:6989-7003. doi: 10.2147/JIR.S483600. eCollection 2024.
To elucidate the predictive values of adipocytokines in patients with acute coronary syndrome (ACS).
Overall, 297 patients with ACS were consecutively enrolled in this prospective cohort study between June 2015 and July 2017 and completed follow-up with a median follow-up time of 6.5 years. For consistency, the last visit date was June 20, 2023. Serum levels of retinol-binding protein-4 (RBP4), interleukin-1β (IL-1β), monocyte chemoattractant protein 1(MCP-1), adrenomedullin (ADM), netrin 1 (NTN 1), and omentin were measured using enzyme-linked immunosorbent assay. Follow-up data were collected during clinical visits or through telephone interviews at 1, 3, 6, 12 months, and annually. The primary endpoint was defined as major adverse cardiovascular events (MACEs), including all-cause mortality, rehospitalization for percutaneous coronary intervention, and severe angina requiring rehospitalization.
All biomarkers displayed a good diagnostic ability of MACEs. The Kaplan-Meier curve showed that the cumulative survival rates of high level of RBP4, IL-1β, and MCP-1 and low level of the ADM, NTN1, and omentin had lower cumulative survival rates (Log rank tests: all p<0.05). After adjustment in the Cox hazard proportional model, the results were RBP4 ≥ 6.87 ng/mL, hazard ratio (HR)=2.512, p=0.003; IL-1β≥ 58.95 pg/mL, HR=3.809, p<0.001; MCP-1 ≥ 401.75 pg/mL, HR=4.047, p<0.001; ADM≤120.01 ng/mL, HR=3.930, p=0.008; NTN1 ≤63.7 pg/mL, HR=3.345, p=0.007; omentin ≤ 4.54 ng/mL, HR=2.830, p=0.004. P-values for interaction were > 0.05 in the sex, age, and dyslipidemia subgroups.
Pro-inflammation adipocytokines RBP4, IL-1β, and MCP-1 increased and anti-inflammation biomarkers ADM, NTN1, and omentin decreased were independently associated with a higher risk of MACEs in patients with ACS.
阐明脂肪细胞因子在急性冠状动脉综合征（ACS）患者中的预测价值。
2015年6月至2017年7月期间，共有297例ACS患者连续纳入本前瞻性队列研究，并完成随访，中位随访时间为6.5年。为保持一致性，最后一次访视日期为2023年6月20日。采用酶联免疫吸附测定法测量血清视黄醇结合蛋白4（RBP4）、白细胞介素-1β（IL-1β）、单核细胞趋化蛋白1（MCP-1）、肾上腺髓质素（ADM）、网蛋白1（NTN 1）和网膜素水平。随访数据在临床访视期间或通过1、3、6、12个月及每年的电话访谈收集。主要终点定义为主要不良心血管事件（MACE），包括全因死亡率、经皮冠状动脉介入治疗再住院率以及需要再住院治疗的严重心绞痛。
所有生物标志物对MACE均显示出良好的诊断能力。Kaplan-Meier曲线显示，高水平的RBP4、IL-1β和MCP-1以及低水平的ADM、NTN1和网膜素的累积生存率较低（对数秩检验：均p<0.05）。在Cox风险比例模型中进行调整后，结果为RBP4≥6.87 ng/mL，风险比（HR）=2.512，p=0.003；IL-1β≥58.95 pg/mL，HR=3.809，p<0.001；MCP-1≥401.75 pg/mL，HR=4.047，p<0.001；ADM≤120.01 ng/mL，HR=3.930，p=0.008；NTN1≤63.7 pg/mL，HR=3.345，p=0.007；网膜素≤4.54 ng/mL，HR=2.830，p=0.004。在性别、年龄和血脂异常亚组中，相互作用的p值>0.05。
促炎脂肪细胞因子RBP4、IL-1β和MCP-1升高以及抗炎生物标志物ADM、NTN1和网膜素降低与ACS患者发生MACE的较高风险独立相关。
