急性冠脉综合征患者血浆PCSK9水平与同型半胱氨酸的相关性研究

    Correlation between plasma PCSK9 levels and homocysteine in patients with acute coronary syndrome

    • 摘要:
      目的 探讨急性冠脉综合征(ACS)患者血浆前蛋白转化酶枯草溶菌素9(PCSK9)水平与同型半胱氨酸(Hcy)之间的相关性。
      方法 选取2022年1月~12月在宁夏医科大学总医院心脏中心确诊为ACS的患者(住院治疗)共105例,根据血浆Hcy水平分为Hcy正常组(n=28)和高同型半胱氨酸血症组(HHcy组,血浆Hcy>15μmol/L,n=77),采集两组患者的临床资料、实验室指标、冠脉造影及介入数据,测定血浆PCSK9和Hcy水平。采用Pearson相关性分析和多因素线性回归方法分析PCSK9与Hcy的相关性。
      结果 与正常组相比,HHcy组男性比例更高(P<0.05)、肾小球滤过率(eGFR)、高密度脂蛋白(HDL-C)下降(P<0.05),白细胞介素-1(IL-1)(P<0.05)、白细胞介素-6(IL-6)(P<0.01)、肿瘤坏死因子α(TNFα)(P<0.05)、PCSK9(P<0.01)升高,SYNTAX积分更高(P<0.05)。Pearson线性相关分析结果显示,PCSK9与Hcy水平呈正相关性(r=0.4126P<0.01),在女性中相关性更显著,女性中相关系数为0.7320(P<0.001),男性中相关系数为0.3567(P<0.01)。多因素回归分析显示,在调整性别、年龄及其他多种临床指标后,血浆Hcy水平每增加1 μmol/L,正常组PCSK9水平增加2.941 pg/ml(95%CI: 1.293,4.588, P<0.01),HHcy组PCSK9水平增加71.277 pg/ml(95%CI: 13.350,129.204, P<0.05)。
      结论  ACS患者血浆PCSK9与Hcy水平存在正相关性,且在女性患者中相关性更显著。

       

      Abstract:
      AIM To investigate the correlation between plasma Proprotein convertase subtilisin/kexin type 9 (PCSK9) and homocysteine (Hcy) in patients with acute coronary syndrome (ACS).
      METHODS A total of 105 patients diagnosed with ACS who were hospitalized in the Heart Center of General Hospital of Ningxia Medical University from January to December 2022 were selected, and the subjects were divided into normal Hcy group and hyperhomocysteinemia (HHcy) group according to plasma Hcy level. Clinical data, laboratory indicators, coronary angiography data, and plasma PCSK9 and Hcy levels were collected. Pearson correlation analysis and multi-factor linear regression method were conducted to analyze the correlation between PCSK9 and Hcy.
      RESULTS Compared with the normal group, the proportion of males in HHcy group was higher (P<0.05), the estimated glomerular filtrationrate (eGFR) and high density lipoprotein cholesterol (HDL-C) were decreased (P<0.05), and interleukin-1 (IL-1) (P<0.05), interleukin-6 (IL-6) (P<0.01), tumor necrosis factor α (TNFα) (P<0.05) and PCSK9 (P<0.01) were increased. The SYNTAX score was higher (P<0.05) in HHcy group than in the normal group (P<0.05). The results of Pearson linear correlation analysis showed that PCSK9 was positively correlated with Hcy level (r=0.4126, P<0.01), and the correlation was more significant in females (the correlation was 0.7320 in females (P<0.001) and 0.3567 in males (P<0.01). Multivariate regression analysis showed that after adjusting for sex, age and other clinical indicators, Compared with normal group, PCSK9 level increased by 2.941pg/ml for every 1μmol/L increase in plasma Hcy level (95%CI: 1.293, 4.588, P<0.01) and level of PCSK9 in HHcy group was increased by 71.277 pg/ml (95%CI: 13.350, 129.204, P<0.05).
      CONCLUSION There is a positive correlation between plasma PCSK9 and Hcy in ACS patients, and the correlation is more significant in female patients.

       

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