目的 探讨补体C1q肿瘤坏死因子相关蛋白1（C1q tumor necrosis factor-related protein 1,CTRP1）与冠状动脉粥样硬化性心脏病(冠心病)间的相关性。方法 根据冠状动脉（冠脉）造影结果提示冠脉管腔狭窄是否≥50%,将研究对象分为冠心病组（103例）和对照组（100例）,采用酶联免疫吸附试验检测CTRP1、脂联素（adiponectin,APN）、肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）、白细胞介素6（(interleukin-6,IL-6）、IL-8、细胞间粘附分子1（intracellular adhesion molecule 1,ICAM-1）、血管细胞粘附分子1（vascular cell adhesion molecule-1,VCAM-1）和单核细胞趋化蛋白1（monocyte chemotactic protein-1,MCP-1）水平,结果应用SPSS 19.0软件进行统计分析。结果 冠心病组的血清CTRP1水平显著高于对照组[（16.68±12.10） ng/mL比(10.27±5.68) ng/mL],差异有统计学意义（P<0.001）。校正性别、年龄、空腹血糖、糖化血红蛋白（hemoglobin A1c,HbA1c）后,冠心病组的血清CTRP1水平与Gensini积分呈正相关（r=0.279,P=0.015）,而Gensini积分的四分位分组中,评分最高组的血清CTRP1水平显著高于其余3组[（23.45±18.87） ng/mL 比（11.27±5.88）ng/mL、（15.15±9.12） ng/mL、（17.00±7.82） ng/mL],差异有统计学意义（P均<0.05）。在冠心病组中,经相关分析显示,校正性别、年龄、空腹血糖、HbA1c后,CTRP1与TNF-α、IL-6、ICAM-1、MCP-1水平（r=0.260、0.448、0.362、0.287,P均<0.05）呈正相关。Logistic回归分析显示,空腹血糖（OR=1.740,95%CI为1.027~2.880,P<0.05）、HbA1c（OR=2.714,95%CI为1.133~6.499,P<0.05）、IL-8（OR=1.041,95%CI为1.008~1.073,P<0.05）、CTRP1（OR=1.136,95%CI为1.060~1.218,P<0.05）水平升高,是冠心病发病的危险因素。结论 血清CTRP1水平在冠脉狭窄≥50%患者中显著升高,且与其冠脉病变严重程度呈正相关,提示血清CTRP1测定有可能成为临床冠脉病变评估的有效指标。
Objective: To investigate the correlation between C1q tumor necrosis factor-related protein 1（CTRP1) and coronary atherosclerotic heart disease（CHD）. Methods: A total of 203 patients with suspected CHD were divided into two groups based on the results of coronary angiography: CHD group(n=103) and control group(n=100). The serum levels of CTRP1, adiponectin（APN）, tumor necrosis factor-α（TNF-α）, IL-6, IL-8, intracellular adhesion molecule 1（ICAM-1）, vascular cell adhesion molecule-1（VCAM-1）and monocyte chemotactic protein-1（MCP-1）were detected by ELISA. SPSS19.0 statistical software was used to analyze the data obtained. Results: The serum level of CTRP1 in CHD group was significantly higher than those in control group [(16.68±; 12.10) ng/mL vs (10.27±; 5.68) ng/mL, P< 0.001 ). After adjusted for gender, age, fasting plasma glucose (FPG) and HbA1c, CTRP1 level in CHD group was correlated with Gensini score（r=0.279, P=0.015）. Based on the quartile of Gensini score, CTRP1 level in the top quartile group was significantly higher than the other three groups [(23.45±; 18.87） ng/mL vs（11.27±; 5.88） ng/mL, （15.15±; 9.12） ng/mL, （17.00±; 7.82） ng/mL, all P< 0.05)]. After adjusted for gender, age, FPG and HbA1c, correlation analysis revealed that CTRP1 was positively correlated with TNF-α, IL-6, ICAM-1, MCP-1（r=0.260, 0.448, 0.362, 0.287, all P< 0.05）. Logistic regression analysis indicated that FPG（OR: 1.740, 95% CI: 1.027-2.880, P< 0.05）, HbA1c（OR: 2.714, 95% CI: 1.133-6.499, P< 0.05）, IL-8（OR: 1.041, 95% CI: 1.008-1.073, P< 0.05）, CTRP1（OR: 1.136, 95% CI:1.060-1.218, P< 0.05） were the risk factors for CHD. Conclusions: Serum CTRP1 level are significantly increased in patients with CHD and are positively correlated with the severity of coronary artery lesion, which suggested that CTRP1 might be used as an efficient indicator for evaluating the severity of CHD.
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