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目的探讨血清成纤维细胞生长因子21(FGF21)、脂联素与冠状动脉性心脏病(冠心病)的相关性。方法入选2013年6月到2014年6月于福建省立医院接受冠状动脉造影检查的375例住院患者,年龄(63.3±9.8)岁,根据造影结果分为冠心病组(n=232)和非冠心病组(n=143)。酶联免疫吸附试验用于测定各组血清中FGF21和脂联素水平。应用多因素Logistic回归分析冠心病与FGF21、脂联素的相关性。结果冠心病组男性、吸烟和糖尿病史比例、年龄、腰臀比、空腹血糖、糖化血红蛋白(HbA1c)水平高于非冠心病组(均P<0.05),FGF21[(357.5±14.0)比(419.2±17.0)ng/L]、脂联素[(6.5±0.5)比(8.1±0.8)mg/L]低于非冠心病组(均P<0.05)。偏相关分析显示,FGF21与冠状动脉病变支数(r=-0.104,P<0.05)和Gensini评分(r=-0.128,P<0.05)呈负相关;Spearman相关分析显示,FGF21与脂联素呈正相关(r_s=0.200,P<0.05)。在校正年龄、性别、吸烟、HbA1c、高密度脂蛋白胆固醇(HDL-C)以及稳态模型评估的胰岛素抵抗指数后,多因素Logistic回归分析结果显示,HDL-C(OR=0.368,P<0.05)和FGF21(OR=0.376,P<0.05)是冠心病的保护因素,年龄(OR=1.032,P<0.05)、HbA1c(OR=2.038,P<0.01)以及吸烟(OR=1.999,P<0.05)是冠心病的危险因素。结论 FGF21是冠心病的保护因素之一,其与脂联素呈正相关,与冠状动脉病变支数和Gensini评分呈负相关。
Objective To investigate the correlation between serum fibroblast growth factor 21 (FGF21), adiponectin and coronary heart disease (coronary heart disease). Methods A total of 375 inpatients undergoing coronary angiography at the Fujian Provincial Hospital from June 2013 to June 2014 were enrolled in this study. Their ages (63.3 ± 9.8) years were divided into coronary heart disease group (n = 232) and non-coronary artery disease group Coronary heart disease group (n = 143). Enzyme-linked immunosorbent assay was used to determine serum levels of FGF21 and adiponectin in each group. Multivariate Logistic regression analysis of coronary heart disease and FGF21, adiponectin correlation. Results The prevalences of smoking, diabetes, age, WHR, fasting blood glucose and HbA1c in CHD group were significantly higher than those in non-CHD group (all P <0.05), FGF21 [(357.5 ± 14.0) ± 17.0 ng / L] and adiponectin [(6.5 ± 0.5) vs (8.1 ± 0.8) mg / L], respectively (all P <0.05). Partial correlation analysis showed that FGF21 was negatively correlated with coronary artery lesion count (r = -0.104, P <0.05) and Gensini score (r = -0.128, P <0.05); Spearman correlation analysis showed that FGF21 was positively correlated with adiponectin (R_s = 0.200, P <0.05). Multivariate logistic regression analysis showed that HDL-C (OR = 0.368, P <0.05) after adjusting for age, sex, smoking, HbA1c, HDL-C and insulin resistance index assessed by homeostasis model ) And FGF21 (OR = 0.376, P <0.05) were the protective factors of coronary heart disease. There was no significant difference in age (OR = 1.032, ) Is a risk factor for coronary heart disease. Conclusion FGF21 is one of the protective factors of coronary heart disease, which is positively correlated with adiponectin, negatively correlated with coronary lesion count and Gensini score.