血清鸢尾素、脂联素水平与颈动脉粥样硬化的关系

Relationship between serum irisin and adiponectin levels and carotid atherosclerosis

摘要:

目的 探讨血清鸢尾素及脂联素（APN）水平与颈动脉粥样硬化的关系。方法 选取2020年1月—2022年1月海南省人民医院收治的124例H型高血压患者作为研究组，另选取同期来该院体检的健康者112例作为对照组。比较两组血清鸢尾素、APN水平，分析研究组颈动脉粥样硬化斑块形成的影响因素，采用受试者工作特征（ROC）曲线分析血清鸢尾素、APN水平预测颈动脉粥样硬化斑块形成的价值。结果 研究组血清鸢尾素、APN水平低于对照组（P <0.05）。斑块形成组与非斑块形成组性别、年龄、体重指数、吸烟史、饮酒史、收缩压、舒张压、血压控制良好、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、一氧化氮、尿酸、肌酐、内皮素水平比较，差异无统计学意义（P >0.05）。斑块形成组甘油三酯、同型半胱氨酸水平高于非斑块形成组（P <0.05），鸢尾素、APN水平低于非斑块形成组（P <0.05）。多因素一般Logistic回归分析结果显示：同型半胱氨酸水平［O^R=4.415（95% CI：1.817，10.730）］、血清鸢尾素水平［O^R=4.027（95% CI：1.657，9.787）］、APN水平［O^R=3.165（95% CI：1.302，7.691）］是影响研究组颈动脉粥样硬化斑块形成的危险因素（P <0.05）。ROC曲线分析显示，鸢尾素、APN水平预测颈动脉粥样硬化斑块形成的最佳截断值分别为3.16和12.24 μg/mL，敏感性分别为82.14%（95% CI：0.631，0.939）、85.71%（95% CI：0.673，0.960），特异性分别为73.96%（95% CI：0.640，0.824）、64.58%（95% CI：0.542，0.741），曲线下面积分别为0.747（95% CI：0.661，0.821）、0.771（95% CI：0.687，0.842），两者联合预测的敏感性、特异性和AUC分别为82.14%（95% CI：0.631，0.939）、94.79%（95% CI：0.883，0.983）、0.886（95% CI：0.816，0.936）。结论 H型高血压患者鸢尾素、APN水平均异常降低，临床检测血清鸢尾素、APN水平可作为预测颈动脉粥样硬化斑块形成的敏感指标。

Abstract:

Objective To investigate the relationship between serum irisin and adiponectin (APN) levels and carotid atherosclerosis.Methods A total of 124 H-type hypertension patients admitted to our hospital from January 2020 to January 2022 were included as the study group, while 112 healthy individuals undergoing health checkup in our hospital during the same period were selected as the control group. Serum levels of irisin and APN in the two groups were compared, and the influencing factors for carotid atherosclerotic plaque formation was analyzed in H-type hypertension patients. The receiver operating characteristic (ROC) curve was used to analyze the value of serum irisin and APN levels in predicting carotid atherosclerotic plaque formation.Results The serum levels of irisin and APN in the study group were lower than those in the control group (P < 0.05). There was no significant difference in sex composition, age, body mass index, history of smoking and alcohol consumption, systolic blood pressure, diastolic blood pressure, blood pressure control and levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, nitric oxide, uric acid, creatinine, and endothelin between patients with plaque formation and those without plaque formation (P > 0.05). The serum levels of triglyceride and homocysteine in patients with plaque formation were higher than those in patients without plaque formation (P < 0.05), while serum levels of irisin and APN were lower in patients with plaque formation than in those without plaque formation (P < 0.05). Multivariable Logistic regression analysis showed that serum levels of homocysteine [O^R = 4.415, (95% CI: 1.817, 10.730) ], irisin [O^R = 4.027, (95% CI: 1.657, 9.787) ], and APN [O^R = 3.165, (95% CI: 1.302, 7.691) ] were risk factors for carotid atherosclerotic plaque formation in H-type hypertension patients (P > 0.05). ROC curve analysis revealed that the optimal cut-off points of serum irisin and APN levels for predicting carotid atherosclerotic plaque formation in H-type hypertension patients were 3.16 μg/mL and 12.24 μg/mL, respectively, with the sensitivity being 82.14% (95% CI: 0.631, 0.939) and 85.71% (95% CI: 0.673, 0.960), the specificity being 73.96% (95% CI: 0.640, 0.824) and 64.58% (95% CI: 0.542, 0.741), and the area under the ROC curve (AUC) being 0.747 (95% CI: 0.661, 0.821) and 0.771 (95% CI: 0.687, 0.842). The sensitivity, specificity and AUC of the combined detection were 82.14% (0.631, 0.939), 94.79% (0.883, 0.983), and 0.886 (0.816, 0.936), respectively.Conclusions Serum levels of irisin and APN are abnormally decreased in H-type hypertension patients, and they are sensitive indicators for predicting carotid atherosclerotic plaque formation.