血清omentin-1、VCAM-1表达与肾移植术后心血管事件发生的相关性研究

孙崇涛; 陈玮; 王万礼

doi:10.13898/j.cnki.issn.1000-2200.2023.10.018

血清omentin-1、VCAM-1表达与肾移植术后心血管事件发生的相关性研究

Correlation between the expressions of serum omentin-1, VCAM-1 and cardiovascular events after renal transplantation

摘要

摘要:
目的对肾移植病人术前、术后血清网膜素-1(omentin-1)和血管细胞黏附分子-1(VCAM-1)表达进行分析，并探讨血清omentin-1和VCAM-1表达水平与肾移植术后心血管事件发生的相关性。
方法选取进行肾移植手术病人105例，将术后发生心血管事件的病人49例分为观察组，未发生心血管事件的病人56例分为对照组；采用酶联免疫吸附法检测病人血清omentin-1和VCAM-1表达水平；采用Pearson法分析omentin-1和VCAM-1表达的相关性；绘制ROC曲线评估omentin-1和VCAM-1水平对肾移植术后心血管事件发生的预测价值；Kaplan-Meier曲线分析血清omentin-1和VCAM-1表达水平与病人术后心血管事件的关系；用COX回归分析法分析影响肾移植术后心血管事件发生的因素。
结果术前2组病人血清omentin-1和VCAM-1表达差异均无统计学意义(P>0.05)；术后观察组血清omentin-1表达水平明显低于对照组(P < 0.01)，血清VCAM-1表达水平明显高于对照组(P < 0.01)；肾移植术后2组病人血清omentin-1和VCAM-1表达呈明显负相关关系(r=-0.734，P < 0.05)；ROC曲线显示，肾移植术后病人血清omentin-1和VCAM-1预测心血管事件发生的ROC曲线下面积(AUC)分别为0.899(95%CI: 0.832~0.966)、0.833(95%CI: 0.747~0.920)，截断值分别为149.25 μg/L、1 142.443 ng/mL，灵敏度分别为91.8%、65.3%，特异性分别为87.5%、98.2%;二者联合预测心血管事件发生的AUC为0.915 (95%CI: 0.853~0.977)，敏感性为87.8%、特异性为89.3%；术后5年心血管事件发生率: omentin-1高表达组病人明显低于omentin-1低表达组，VCAM-1高表达组病人明显高于VCAM-1低表达组(P < 0.01和P < 0.05)。血清omentin-1高表达是影响哮肾移植病人术后发生心血管事件的独立保护因素(P < 0.01)，血清VCAM-1高表达与高血糖是影响肾移植病人术后发生心血管事件的独立危险因素(P < 0.01和P < 0.05)。
结论血清omentin-1与VCAM-1表达与肾移植术后心血管事件发生密切相关，可以作为肾移植术后心血管事件发生的预测指标。

Abstract:
ObjectiveTo analyze the expressions of omentin-1 and vascular cell adhesion molecule-1 (VCAM-1) before and after renal transplantation, and to explore the correlation between the expressions of omentin-1 and VCAM-1 and cardiovascular events after renal transplantation.
MethodsA total of 105 patients with renal transplantation were selected.Among them, 49 patients with cardiovascular events after operation were defined as the study group, and 56 patients without cardiovascular events were defined as the control group.The levels of serum omentin-1 and VCAM-1 were detected by enzyme-linked immunosorbent assay.Pearson method was used to analyze the correlation between the expressions of omentin-1 and VCAM-1.ROC curve was drawn to evaluate the predictive value of omentin-1 and VCAM-1 levels on cardiovascular events after renal transplantation.Kaplan-Meier curve was used to analyze the relationship between the expression levels of serum omentin-1 and VCAM-1 and postoperative cardiovascular events.COX regression analysis was used to analyze the risk factors of cardiovascular events after renal transplantation.
ResultsThere was no significant difference in the expressions of serum omentin-1 and VCAM-1 between the two groups before operation (P>0.05).After operation, the expression level of serum omentin-1 in the study group was significantly lower than that in the control group (P < 0.01), and the expression level of VCAM-1 in the study group was significantly higher than that in the control group (P < 0.01).After renal transplantation, the expressions of serum omentin-1 and VCAM-1 were negatively correlated (r=-0.734, P < 0.05).ROC curve showed that the area under the ROC curve (AUC) of serum omentin-1 and VCAM-1 in predicting cardiovascular events was 0.899 (95%CI: 0.832-0.966) and 0.833 (95%CI: 0.747-0.920), and the cut-off value was 149.25 μg/L and 1142.443 ng/mL, the sensitivity was 91.8% and 65.3%, and the specificity was 87.5% and 98.2%.The AUC of the combined prediction was 0.915 (95%CI: 0.853-0.977), the sensitivity was 87.8%, and the specificity was 89.3%.The incidence of cardiovascular events 5 years after operation was as follows: patients in the high expression group of omentin-1 were significantly lower than those in the low expression group, and patients in the high expression group of VCAM-1 were significantly higher than those in the low expression group (P < 0.01 and P < 0.05).The high expression of serum omentin-1 was an independent protective factor of cardiovascular events in patients with asthma after renal transplantation (P < 0.01), and the high expression of serum VCAM-1 and hyperglycemia were the independent risk factors of cardiovascular events after renal transplantation (P < 0.01 and P < 0.05).
ConclusionsThe expressions of serum omentin-1 and VCAM-1 are closely related to the occurrence of cardiovascular events after renal transplantation, and can be used as predictors of cardiovascular events after renal transplantation.

HTML全文

参考文献(15)

施引文献

资源附件(0)