Evaluation of serum IL-34, GLP-1 and vaspin on cardiovascular adverse events in elderly patients with acute myocardial infarction
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摘要: 目的 探讨血清白介素34(IL-34)、胰高血糖素样肽-1(GLP-1)和脂肪特异性丝氨酸蛋白酶抑制剂(vaspin)对老年急性心肌梗死(AMI)患者心血管不良事件发生的预测价值。方法 选取2017年1月-2019年1月期间我院心血管内科收治的老年AMI患者180例(AMI组)。另选取我院体检健康者100例(对照组)。采用酶联免疫吸附法检测各组血清IL-34、GLP-1、vaspin水平。随访6个月，根据患者有无不良心血管事件发生，分为事件组和非事件组。应用多因素logistic回归分析影响AMI患者心血管不良事件发生的危险因素；绘制受试者工作曲线(ROC)，分析血清IL-34、GLP-1、vaspin对AMI患者发生心血管不良事件的预测价值。结果 AMI组血清IL-34、GLP-1、vaspin水平分别与对照组血清IL-34、GLP-1、vaspin水平相比，差异有统计学意义(P< 0.05)。事件组患者的血清IL-34、GLP-1高于非事件组患者，血清vaspin水平低于非事件组患者，差异有统计学意义(P< 0.05)。ROC曲线示，联合检测血清IL-34、GLP-1、vaspin预测AMI患者发生心血管不良事件的AUC为0.918，敏感度和特异度分别为0.909、0.686。多因素logistic回归分析示：血清IL-34、GLP-1升高，血清vaspin降低是AMI患者发生心血管不良事件的独立危险因素(P< 0.05)。结论 老年AMI患者血清IL-34、GLP-1水平升高，血清vaspin水平降低，并与患者不良心血管事件发生有关，早期联合检测血清IL-34、GLP-1、vaspin对评估老年AMI患者心血管不良事件发生的有较高临床价值。
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关键词:
- 白介素34 /
- 胰高血糖素样肽-1 /
- 脂肪特异性丝氨酸蛋白酶抑制剂 /
- 急性心肌梗死 /
- 心血管不良事件
Abstract: Objective To investigate the predictive value of serum IL-34, GLP-1 and vaspin on cardiovascular adverse events in elderly patients with acute myocardial infarction(AMI).Methods A total of 180 elderly AMI patients(AMI group) admitted to our department from January 2017 to January 2019 were selected. Another 100 healthy subjects(control group) were selected in our hospital. Serum levels of interleukin-34(IL-34), glucagon-like peptide-1(GLP-1)and lipid-specific serine protease inhibitors (vaspin) in each group were detected by enzyme-linked immunosorbent assay. After 6 months of follow-up, the patients were divided into event group and non-event group according to the occurrence of adverse cardiovascular events. Multivariate logistic regression was used to analyze the risk factors of cardiovascular adverse events in patients with AMI. Receiver operating curve(ROC) was drawn to analyze the predictive value of serum IL-34, GLP-1 and vaspin for cardiovascular adverse events in patients with AMI.Results The levels of serum IL-34, GLP-1 and vaspin in the AMI group were significantly different from those in the control group(P< 0.05). The serum IL-34 and GLP-1 levels of the patients in the event group were higher than those in the non-event group, and the serum vaspin level was lower than that in the non-event group, and the differences were statistically significant(P< 0.05). The ROC curve showed that the combined detection of serum IL-34, GLP-1 and vaspin had an AUC of 0.918 for predicting adverse cardiovascular events in patients with AMI, with a sensitivity and specificity of 0.909 and 0.686, respectively. Multivariate logistic regression analysis showed that the increased serum IL-34 and GLP-1 and the decreased serum vaspin were independent risk factors for cardiovascular adverse events in patients with AMI(P< 0.05).Conclusion The levels of serum IL-34 and GLP-1 are increased and the levels of serum vaspin are decreased in elderly AMI patients, which is related to the occurrence of adverse cardiovascular events in patients. Early combined detection of serum IL-34, GLP-1 and vaspin has high clinical value in evaluating the occurrence of cardiovascular adverse events in elderly AMI patients.-
Key words:
- IL-34 /
- glucagon-like peptide-1 /
- vaspin /
- acute myocardial infarction /
- cardiovascular adverse events
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表 1 AMI组与对照组血清IL-34、GLP-1、vaspin比较
x±S 组别 例数 IL-34/(pg·mL-1)) GLP-1/(pmol·L-1) vaspin/(ng·mL-1) AMI组 180 83.85±19.62 42.17±12.28 0.68±0.31 对照组 100 46.11±10.27 11.65±4.13 1.30±0.44 t 6.825 7.496 5.311 P 0.000 0.000 0.001 
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表 2 事件组与非事件组患者临床资料及血清IL-34、GLP-1、vaspin比较
例, x±S 指标 事件组(76例) 非事件组(104例) t/χ2 P 年龄/岁 69.46±8.13 67.61±9.20 0.499 0.572 性别 男 44 66 0.573 0.536 女 32 38 BMI(kg/m2) 24.53±1.77 24.08±1.61 0.351 0.708 吸烟史 有 36 55 0.535 0.546 无 40 49 饮酒史 有 42 48 1.457 0.291 无 34 56 高血压 有 31 40 0.100 0.760 无 45 64 冠心病 有 29 31 1.378 0.265 无 47 73 糖尿病 有 20 25 0.121 0.731 无 56 79 发病至PCI时间/h 6.89±1.73 6.14±1.25 0.726 0.315 Killip分级 Ⅰ~Ⅱ级 31 69 11.616 0.001 Ⅲ~Ⅳ级 45 35 LVEF/% 54.11±6.20 59.38±7.03 4.319 0.005 术后TIMI分级 2级 41 20 23.622 <0.001 3级 35 84 TG/(mmol·L-1) 1.91±0.52 1.83±0.61 1.018 0.107 TC/(mmol·L-1) 4.37±1.26 4.15±1.09 0.290 0.816 HDL-C/(mmol·L-1) 0.94±0.35 1.12±0.47 0.536 0.480 LDL-C/(mmol·L-1) 2.28±0.70 2.46±0.83 0.911 0.203 IL-34/(pg·mL-1) 120.37±25.65 68.24±16.29 5.740 <0.001 GLP-1/(pmol·L-1) 60.13±15.47 27.55±9.21 6.241 <0.001 Vaspin/(ng·mL-1) 0.41±0.11 0.83±0.35 5.107 0.001
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表 3 血清IL-34、GLP-1、vaspin与LVEF的相关性分析
组别 IL-34 GLP-1 vaspin r -0.537 -0.612 0.564 P 0.001 0.001 0.001
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表 4 老年AMI患者发生心血管不良事件的相关危险因素分析
自变量 β SE P OR 95%CI Killip分级 0.513 0.246 0.019 1.271 1.015~3.827 LVEF -0.469 0.207 0.104 0.365 0.247~0.910 术后TIMI分级 -0.627 0.385 0.006 0.411 0.329~0.876 IL-34 0.358 0.164 0.001 1.523 1.160~4.591 GLP-1 0.213 0.097 0.001 2.016 1.584~6.217 vaspin -0.256 0.108 0.001 0.374 0.299~0.863
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[1] 张颖, 乔帅华, 陈建州, 等. 左室相对室壁厚度对急性ST段抬高型心肌梗死患者临床预后的预测价值[J]. 临床心血管病杂志, 2021, 37(5): 411-417. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202105005.htm
[2] Masuda J, Kishi M, Kumagai N, et al. Rural-Urban Disparity in Emergency Care for Acute Myocardial Infarction in Japan[J]. Circ J, 2018, 82(6): 1666-1674. doi: 10.1253/circj.CJ-17-1275
[3] 张海宁, 杨会萍, 任骞, 等. 血清BDNF和CA125水平对急性心肌梗死患者病情及预后的评估价值[J]. 疑难病杂志, 2020, 19(1): 12-16. doi: 10.3969/j.issn.1671-6450.2020.01.004
[4] Baghdadi M, Endo H, Tanaka Y, et al. Interleukin 34, from pathogenesis to clinical applications[J]. Cytokine, 2017, 99: 139-147. doi: 10.1016/j.cyto.2017.08.020
[5] 王东娟, 李恒栋, 谢小玲, 等. 胰高血糖素样肽1通过Keap1-Nrf2信号通路减轻糖尿病大鼠心肌微血管损伤[J]. 中国病理生理杂志, 2019, 35(12): 2143-2149. doi: 10.3969/j.issn.1000-4718.2019.12.005
[6] Lebherz C, Schlieper G, Möllmann J, et al. GLP-1 Levels Predict Mortality in Patients with Critical Illness as Well as End-Stage Renal Disease[J]. Am J Med, 2017, 130(7): 833-841. doi: 10.1016/j.amjmed.2017.03.010
[7] 闫杰, 刁增利, 葛庆锋, 等. LOX-1和Vaspin在冠心病患者体内的表达及其与PCI术后再狭窄的关系[J]. 东南大学学报(医学版), 2018, 37(5): 882-886. doi: 10.3969/j.issn.1671-6264.2018.05.027
[8] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2015, 43(5): 380-393. doi: 10.3760/cma.j.issn.0253-3758.2015.05.003
[9] 方子美, 陈小芳, 余向东. 血清FGF23、Fetuin-A检测对STEMI患者PCI术后发生MACE的预测价值[J]. 山东医药, 2019, 59(25): 22-26. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY201925007.htm
[10] 侯清濒, 靳春荣, 白雪琦, 等. 血清3-NT与急性ST段抬高型心肌梗死的相关性及其对行急诊经皮冠状动脉介入术后1年预后的预测价值[J]. 临床心血管病杂志, 2020, 36(3): 233-237. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202003009.htm
[11] Fan Q, Tao R, Zhang H, et al. Interleukin-34 Levels Were Associated with Prognosis in Patients with Acute Myocardial Infarction[J]. Int Heart J, 2019, 60(6): 1259-1267. doi: 10.1536/ihj.19-111
[12] 刘洋, 姜馨. 白细胞介素-34与心血管疾病关系研究进展[J]. 中国分子心脏病学杂志, 2019, 19(5): 3090-3092. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGFB201905014.htm
[13] 张文才, 宫俊龙, 赵洛沙. 血清白细胞介素-34水平与冠心病严重程度的关系[J]. 临床心血管病杂志, 2019, 35(8): 702-705. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB201908006.htm
[14] Kahles F, Rückbeil MV, Mertens RW, et al. Glucagon-like peptide 1 levels predict cardiovascular risk in patients with acute myocardial infarction[J]. Eur Heart J, 2020, 41(7): 882-889.
[15] Diebold S, Moellmann J, Kahles F, et al. Myocardial infarction is sufficient to increase GLP-1 secretion, leading to improved left ventricular contractility and mitochondrial respiratory capacity[J]. Diabetes Obes Metab, 2018, 20(12): 2911-2918. doi: 10.1111/dom.13472
[16] 刘秋梅, 张爱文, 金凤表, 等. 血清内皮细胞特异分子-1、脂肪特异性丝氨酸蛋白酶抑制剂水平对微血管性心绞痛诊断的临床价值[J]. 中国循环杂志, 2019, 34(4): 351-356. doi: 10.3969/j.issn.1000-3614.2019.04.008
[17] 黄为俊, 李艺乐, 李同社. 血清CX3CL1、TXNIP和Vaspin表达水平与冠心病患者病变程度的关系[J]. 心脑血管病防治, 2019, 19(4): 318-321, 324. https://www.cnki.com.cn/Article/CJFDTOTAL-XXFZ201904010.htm
[18] Zhou X, Chen Y, Tao Y, et al. Serum Vaspin as a Predictor of Adverse Cardiac Events in Acute Myocardial Infarction[J]. J Am Heart Assoc, 2019, 8(2): e010934. doi: 10.1161/JAHA.118.010934
[19] 张远恒, 陈绪江. 血清vaspin预测AMI患者PCI术后不良心脏事件的价值分析[J]. 西南国防医药, 2019, 29(11): 1110-1113. doi: 10.3969/j.issn.1004-0188.2019.11.007
[20] 曾云洁, 陈丽华. 老年冠心病患者musclin、缺血修饰白蛋白、胰高血糖素样肽-1水平与其病变严重程度的关系研究[J]. 临床内科杂志, 2021, 38(4): 247-249. doi: 10.3969/j.issn.1001-9057.2021.04.010
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