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目的:研究冠心病患者血浆Apelin与胰岛素抵抗及炎症的关系。方法:选择无糖尿病病史的患者90例,所有患者行冠状动脉造影,其中冠心病患者(冠心病组)50例和无冠心病患者(对照组)40例,收集一般临床资料,测量血压,腰围,臀围,测定空腹血糖,空腹胰岛素,超敏C-反应蛋白(hsCRP)等生化指标,采用ELISA法测定2组患者血浆Apelin水平,并用胰岛素抵抗指数(IRI)作为胰岛素敏感性评价指标。结果:经单因素分析发现,腰围、空腹胰岛素、IRI、hsCRP及Apelin在冠心病组和对照组之间差异有统计学意义(P<0.05);多因素分析发现,高血压病史、腰围、IRI、hsCRP与冠心病呈正相关(OR值分别是2.141、1.039、1.111、4.327,均P<0.05),Apelin与冠心病呈负相关(OR值为0.845,P<0.05)。冠心病组患者Apelin与各指标作相关分析显示:Apelin与腰围、IRI和hsCRP呈负相关(r值分别为-0.196,-0.423,-0.314,均P<0.05)。结论:Apelin可能与冠心病发病密切相关,Apelin在联系炎症、胰岛素抵抗与冠心病之间可能发挥着重要的作用。
Objective: To study the relationship between plasma Apelin and insulin resistance and inflammation in patients with coronary heart disease. Methods: Ninety patients with no history of diabetes mellitus were selected. All patients underwent coronary angiography. Among them, 50 patients with coronary heart disease (CHD) and 40 patients without coronary heart disease (control group) were enrolled in this study. General clinical data, blood pressure, waist circumference , Hips, fasting blood glucose, fasting insulin, hsCRP and other biochemical indicators. The plasma levels of Apelin in two groups were measured by ELISA. The insulin resistance index (IRI) was used as the index of insulin sensitivity. Results: According to univariate analysis, waist circumference, fasting insulin, IRI, hsCRP and Apelin were significantly different between CHD group and control group (P <0.05). Multivariate analysis showed that the history of hypertension, waist circumference, IRI , HsCRP was positively correlated with coronary heart disease (OR = 2.141,1.039,1.111,4.327, all P <0.05). Apelin was negatively correlated with coronary heart disease (OR = 0.845, P <0.05). Correlation analysis between Apelin and each index showed that Apelin was negatively correlated with waist circumference, IRI and hsCRP (r = -0.196, -0.423, -0.314, all P <0.05). Conclusion: Apelin may be closely related to the pathogenesis of coronary heart disease. Apelin may play an important role in the connection between inflammation, insulin resistance and coronary heart disease.