慢性心功能不全患者血浆Chemerin变化及临床意义

摘要

Objective:To compare plasma Chemerin levels in patients with chronic heart failure(CHF) and in control subjects,and assesse the association of plasma Chemerin with body composition and metabolic parameters in these subjects.Methods:Serum Chemerin and Tumor Necrosis Factor-α(TNF-α) levels were measured by ELISA in 52 patients with CHF and in 52 age,tender,diabetes-history matched controls with cardiovascular disease but normal heart function, and in 26 healthy volunteers.Furthermore,the association between chemerin and NT-proBNP,TNF-α as well as metabolism markers were studied. Results:Plasma Chemerin levels were found to be markedly increased in patients with CHF as compared with patients without CHF and normal controls(P<0.001). Multiple regression analysis showed that TG(r=0.270,P=0.021),body mass index(r=0.250,P=0.029),HOMA-IR(r=0.319,P=0.005) and TNF-α(r=0.348, P=0.003) were independently related factors influencing plasma Chemerin levels.Conclusion:The present work indicates the potential role of Chemerin in the pathogenesis of chronic heart failure through the immune response.%　　目的：探讨慢性心功能不全患者血清脂肪因子Chemerin的变化及其临床意义。方法：52例慢性左心功能不全(射血分数EF<45%)患者，以年龄、性别和有无糖尿病史1∶1匹配选取心功能正常患者作为非心衰对照组，26例健康人群为正常对照组，检测体质指数、NT-proBNP等临床及生化指标，ELISA方法检测血浆Chemerin和肿瘤坏死因子α(TNF-α)水平，进行对比研究。结果：心衰患者血浆Chemerin水平较非心衰患者(P<0.001)及正常对照组(P<0.001)明显升高，且随心衰加重而明显升高，多元回归分析显示甘油三酯(r=0.270，P=0.021)、HOMA-IR(r=0.319，P=0.005)、体质指数(r=0.250，P=0.029)、肿瘤坏死因子-α(r=0.348，P=0.003)是影响Chemerin水平的相关因素。结论：Chemerin不仅参与肥胖和代谢综合征的内分泌调节，亦通过参与免疫炎症反应，在心力衰竭的发生发展中发挥重要作用。