The expression of plasma Vaspin in patients with heart failure and its clinical significance
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摘要: 目的 探讨心力衰竭(HF)患者血浆内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)的表达及其临床意义。方法 选取2020年12月—2021年4月山西医科大学第二医院心内科住院患者87例，根据是否患有HF，分为非HF组(16例)和HF组(71例)。HF组根据左室射血分数(LVEF)分为射血分数保留型心力衰竭(HFpEF)组39例、射血分数中间值心力衰竭(HFmrEF)组10例和射血分数降低型心力衰竭(HFrEF)组22例。收集年龄、性别、合并冠心病、合并2型糖尿病情况、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肾小球滤过率(eGFR)、N末端B型利钠肽前体(NT-proBNP)等生化指标。酶联免疫吸附法(ELISA)测定血浆Vaspin水平。超声心动图测量左房内径(LAD)、左室舒张末期内径(LVEDd)、LVEF。结果 四组间比较，HFpEF组、HFmrEF组、HFrEF组血浆Vaspin浓度均低于非HF组(P< 0.05)，HFpEF组、HFmrEF组、HFrEF组组间差异无统计学意义(P>0.05)。HF组血浆Vaspin浓度低于非HF组(P< 0.01)。Spearman相关分析显示血浆Vaspin与HF发生呈负相关(P< 0.05)。二元Logistic回归分析显示，低水平TC及低水平Vaspin为HF的影响因素(P< 0.05)。血浆Vaspin水平预测HF发生的绘制受试者工作特征曲线(ROC)的曲线下面积(AUC)为0.799(95%CI：0.706~0.893，P< 0.01)，最佳临界值为22.79 ng/mL，灵敏度、特异度分别为74.6%和81.2%。结论 HF患者Vaspin水平显著降低，与HF呈负相关，可预测HF。Abstract: Objective To explore the expression of plasma Visceral adipose tissue-derived serine protease inhibitor (Vaspin) in patients with Heart failure (HF) and its clinical significance.Methods A total of 87 inpatients in the Second Hospital of Shanxi Medical University from December 2020 to April 2021 were selected. They were divided into the non-HF group (16 cases) and the HF group(71 cases). According to the left ventricular ejection fraction (LVEF), the HF group was divided into preserved ejection fraction heart failure (HFpEF) group(39 cases), median ejection fraction heart failure (HFmrEF) group(10 cases), and reduced ejection fraction heart failure(HFrEF) group(22 cases). We collected age, gender, patients with coronary heart disease and type 2 diabetes, total cholesterol(TC), triglycerides(TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol(LDL-C), glomerular filtration rate(eGFR), N-terminal B-type natriuretic peptide precursor (NT-proBNP), and other biochemical indicators. Enzyme-linked immunosorbent assay (ELISA)was used to determine the plasma Vaspin levels. Echocardiography measured left atrial inner diameter (LAD), left ventricular end-diastolic diameter (LVEDd), and LVEF.Results The plasma Vaspin concentration in the HFpEF, HFmrEF, and HFrEF groups was lower than the non-HF group (P< 0.05), and there was no statistical difference between the HFpEF, HFmrEF, and HFrEF groups (P>0.05). The plasma Vaspin concentration in the total HF group was lower than that in the non-HF group (P< 0.01). Spearman correlation analysis showed that plasma Vaspin was negatively correlated with the occurrence of HF(P< 0.05). Binary Logistic regression analysis showed the low-level TC and low-level Vaspin as influent factors of HF(P< 0.05). The AUC for the prediction of HF by plasma Vaspin levels was 0.799[95%CI: 0.706~0.893,P< 0.01], the best cut-off value was 22.79 ng/mL, and sensitivity and specificity were 74.6% and 81.2%.Conclusion Vaspin levels in patients with HF are significantly reduced, which is negatively correlated with HF and can predict HF.
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Key words:
- heart failure /
- Vaspin /
- prediction /
- influent factors
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图 1 血浆Vaspin水平检测HF价值的ROC曲线
Figure 1. ROC curve of plasma Vaspin level in detecting HF value
表 1 4组受试者基线资料比较
Table 1. Comparison of baseline data of 4 groups of subjects
例(%), M(Q1, Q3), X±S 变量 非HF组(16例) HFpEF组(39例) HFmrEF组(10例) HFrEF组(22例) t/χ2 P 男性 8(50.00) 24(61.50) 8(80.00) 15(68.20) 2.335 0.506 年龄/岁 69.24±6.92 73.84±12.63 67.00±15.11 62.05±15.262) 30.646 0.037 BMI/(kg·m-2) 23.98±2.29 23.53±5.38 24.37±4.03 22.05±3.27 31.531 0.204 合并冠心病 2(12.00) 18(46.00) 7(70.00)1) 10(45.00) 10.111 0.018 合并2型糖尿病 3(19.00) 9(23.00) 2(20.00) 4(18.00) 0.338 0.979 eGFR/[mL·min-1·(1.73m2)-1] 111.84±28.82 73.01±29.711) 76.06±33.691) 80.55±33.541) 6.429 0.001 TC/(mmol·L-1) 5.00±1.51 3.70±1.131) 3.50±0.611) 2.97±0.701)2) 10.903 < 0.001 TG/(mmol·L-1) 1.20(1.07，2.17) 0.97(0.73，1.60) 0.98(0.67，1.50) 0.87(0.70，0.98)1) 11.106 0.011 HDL-C/(mmol·L-1) 1.23±0.36 1.12±0.36 1.16±0.33 0.99±0.351) 1.535 0.212 LDL-C/(mmol·L-1) 2.32±0.49 1.97±0.85 1.88±0.47 1.69±0.501) 2.648 0.055 NT-proBNP/(ng·L-1) 71(65，125) 1956(1151，5000)1) 2014(1013，4224)1) 5217(1159，8334)1) 40.113 < 0.001 LAD/mm 32.47±2.94 39.45±10.601) 42.9±4.461) 45.15±6.271)2) 8.624 < 0.001 LVEDd/mm 48.00±3.50 49.36±7.62 58.90±6.571)2)3) 64.80±9.561)2) 23.700 < 0.001 LVEF/% 69.50(66.00，71.00) 62.00(56.00，67.00) 42.50(40.75，46.25)1)2) 29.50(23.00，34.00)1)2) 66.522 < 0.001 Vaspin/(ng·mL-1) 24.70±3.04 19.53±5.711) 19.25±4.851) 18.71±7.041) 4.450 0.006 注：与非HF组比较，1)P < 0.05；与HFpEF组比较，2)P < 0.05；与HFrEF比较，3)P < 0.05。 
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表 2 血浆Vaspin的相关性比较
Table 2. Correlation comparison of plasma Vaspin
变量 血浆Vaspin浓度 r P BMI 0.073 0.515 eGFR 0.287 0.007 TC 0.239 0.033 TG 0.270 0.014 NT-proBNP -0.413 0.000 LVEF 0.221 0.039 HF -0.402 0.000
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表 3 非HF组与HF组之间的二元logistic回归
Table 3. Binary logistic regression between non-HF group and HF group
影响因素 B值 SE Wals值 P值 OR值 95%CI 下限 上限 TC -1.200 0.367 10.675 0.001 0.301 0.147 0.619 Vaspin -0.204 0.086 5.598 0.018 0.815 0.688 0.966
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