瘦素、脂肪酸合成酶、雌激素与冠状动脉血管钙化的关系

Relationship between serum levels of leptin，FAS，estrogen and cardiovascular calcification

摘要:

目的：探讨瘦素、脂肪酸合成酶（fatty acid synthetase，FAS）以及雌激素（estrogen，E）与冠脉血管钙化的关系。方法：将研究对象根据冠脉造影分为冠心病组（98例：男53例，女45例）和非冠心病组（89例：男47例，女42例），对纳入对象分别计算各冠状动脉钙化积分及冠脉总钙化积分，同时用放射免疫法检测血清瘦素、FAS、E、甘油三酯（triglyceride，TG）、胆固醇（total choles－terol，TC）、Ｃ－反应蛋白（C-reactive protein，CRP）、低密度脂蛋白胆固醇（low density lipoprotein-cholesterol，LDL-C）、高密度脂蛋白胆固醇（high density lipoprotein-cholesterol，HDL-C）、血清磷（P3-）、血清钙（Ca2+）水平。结果：冠心病组血清 FAS、瘦素及钙化积分显著高于非冠心病组（P＜0.05），而血清E水平显著低于非冠心病组（P<0.05）；冠脉钙化水平与瘦素（r=0.640，P<0．05）、FAS（r=0.420，P<0．05）、TG（r=0.120，P<0．05）、TC（r=0.179，P<0．05）、CRP（r=0.125，P<0．05）呈正相关、与E（r=-0.453，P<0．05）、HDL-C（r=-0.110，P<0．05）呈负相关；进入回归方程的因素为瘦素、FAS、E、TG、TC、HDL－C。结论：冠心病患者血清E水平显著低，提示E可能具有保护血管、拮抗钙化的效应；而患者血清瘦素、 FAS浓度水平明显升高，瘦素、FAS水平可能参与血管钙化的发生发展。

Abstract:

Objective：To investigate the relationship between serum levels of leptin，fatty acid synthase（FAS），estrogen（E） and cardio－vascular calcification. Methods：Totally 187 patients were divided into two groups by coronary angiography：coronary heart disease group （n=98，53 males and 45 females） and non-coronary heart disease group（n=89，47 males and 42 females）. Coronary artery cal－cification scores were calculated respectively in two groups. Meanwhile，serum levels of leptin，FAS，E，triglyceride（TG），total cholesterol（TC），C-reactive protein（CRP），low density lipoprotein-cholesterol（LDL-C），high density lipoprotein-cholesterol（HDL-C），P3- and Ca2+ of the two groups were measured by radioimmunoassay. Results：Serum leptin and FAS concentrations as well as coronary artery calcification scores were significantly higher in coronary heart disease group than in non-coronary heart disease group（P<0.05）. But the serum level of E was lower in coronary heart disease group than in non-coronary heart disease group（P<0.05）. Level of cardiovascular calcification was positively correlated with leptin（r=0.640，P<0.05），FAS（r=0.420，P<0.05），TG（r=0.120，P<0.05），TC（r=0.179，P<0.05），CRP（r=0.125，P<0.05） but negatively with E（r=-0.453，P<0.05） and HDL-C（r=-0.110，P<0.05）. Stepwise multiple regression analysis showed that factors of leptin，FAS，E，TG，TC and HDL-C entered the regression equation. Conclusions：Serum level of E is lower in those with coronary heart disease，which suggests that E may protect cardiovascular by antagonizing vas－cular calcification. Serum leptin and FAS concentrations of those with coronary heart disease are significantly increased indicating that leptin and FAS may promote the development of cardiovascular calcification.