Diyabetik olmayan ST yükselmesiz miyokard enfarktüsü hastalarında serum vaspin düzeyi ile koroner arter hastalığının şiddeti arasındaki ilişki

Yıl 2023, , 136 - 140, 30.06.2023

Jihat Balı Umut Karabulut , Ahmet Büyük Cengiz Çeliker

https://doi.org/10.34087/cbusbed.1002213

Öz

Giriş ve Amaç: Vaspin bir adipositokin, serin proteaz inhibitörüdür ve obezite, insülin duyarlılığı, diabetes mellitus ve koroner arter hastalığı ile ilişkilidir. Vaspin ve koroner arter hastalığı arasındaki ilişki çeşitli çalışmalarda gösterilmiştir. Koroner arter hastalığı olan hastalarda bu değerin diyabetten bağımsız olup olmadığı ise bilinmemektedir. Ayrıca ST elevasyonsuz miyokard enfarktüslü (NONSTEMI) hastalarda vaspinin önemini gösteren bir çalışma yapılmamıştır. Bu çalışmada, diyabetik olmayan NONSTEMI hastalarında serum vaspin düzeyleri ile SYNTAX skoru ile belirlenen koroner arter hastalığı şiddeti arasındaki ilişkinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: NONSTEMI'li toplam 165 diyabetik olmayan hasta, kesitsel olarak çalışmaya dahil edildi. Serum vaspin seviyeleri ELISA yöntemi ile ölçüldü. SYNTAX skorları, anjiyografi sonuçlarına (çift kör) iki uzman operatör tarafından değerlendirildi. Hastalar çeyrekler arası aralık yöntemi ile SYNTAX skoruna göre üç gruba ayrıldı (Grup 1 SS <10, grup 2 10 ≤ SS≤22, grup 3 SS> 22).
Bulgular: Serum vaspin düzeyleri üç grup arasında anlamlı olarak farklı (p = 0,03) ve grup 1'de grup 3'e göre anlamlı olarak yüksek bulundu (p = 0,01). Grup 1 ve 2 ile grup 2 ve grup 3 arasında anlamlı fark bulunmadı. (p = 0, 52, p = 0.06). SYNTAX skoru ile serum vaspin seviyeleri arasında anlamlı ancak zayıf bir negatif korelasyon olduğu bulundu (r = -0.207, p = 0.008).
Sonuç: Vaspin, SYNTAX skoru ile negatif korelasyon göstermektedir ve diyabetik olmayan NONSTEMI hastalarında koroner hastalığın şiddetini göstermek için yararlı bir belirteç olabilir.

Anahtar Kelimeler

Vaspin, NONSTEMI, diyabetik olmayan, SYNTAX

Relationship between serum vaspin levels and the severity of coronary disease in non-diabetic patients with non-ST elevation myocardial infarction

Öz

Objectives: Vaspin is an adipocytokine, serine protease inhibitor, correlated to obesity, insülin sensitivity, diabetes mellitus, and coronary artery disease. The association between vaspin and coronary artery disease was shown in several studies. Whether this value is independent of diabetes in coronary artery disease patients is not known. Also, a study that shows the importance of vaspin in patients with Non-ST elevation myocardial infarction (NONSTEMI) is not conducted. This study aimed to investigate the relationship between serum vaspin levels and the severity of coronary artery disease, which is determined by the SYNTAX score, in nondiabetic patients with NONSTEMI
Materials and Methods: A total of 165 nondiabetic patients with NONSTEMI were included in this cross-sectional study. Serum vaspin levels were measured by the ELISA method.SYNTAX scores were evaluated by two expert operators blinded to the angiography results. Patients were divided into three groups according to the SYNTAX score by the interquartile range method (group 1 with SS <10, group 2 with 10 ≤ SS≤22, group 3 with SS> 22).
Results: Serum vaspin levels were found significantly different between three groups (p = 0,03) and significantly higher in group 1 than group 3 (p = 0,01).No significant difference was found between group 1 and 2 also group 2 and 3 (p = 0, 52, p = 0.06 ).It was found to be a significant but weak negative correlation between the SYNTAX score and serum vaspin levels (r = -0,207, p = 0.008).
Conclusion: Vaspin negatively correlates to SYNTAX score and maybe a useful marker to show the severity of coronary disease in nondiabetic patients with NONSTEMI

Anahtar Kelimeler

Vaspin, NONSTEMI, nondiabetic, SYNTAX

Kaynakça

• 1-Buğan B, Çelik T, Risk factors for coronary artery disease, J. Clin. Anal. Med. 2014;5(2): 159-63
• 2- Gülçelik NE, Usman A, Gürlek A., Role of adipocytokines in predicting the development of diabetes and its late complications. Endocrine 2009;36(3):397–403.
• 3- Northcott JM, Yeganeh A, Taylor CG, Zahradka P, Wigle JT. Adipokines and the cardiovascular system: mechanisms mediating health and disease, Can J Physiol Pharmacol 2012;90(8):1029–59
• 4-Yamawaki H., Vascular effects of novel adipocytokines: focus on vascular contractility and inflammatory responses. Biol Pharm Bull 2011;34(3):307–10.
• 5-Rabe K, Lehrke M, Parhofer KG, Broedl UC. Adipokines and insulin resistance. Mol Med 2008;14(11-12):741-51
• 6- Ye Y, Hou XH, Pan XP, Lu JX, Jia WP. Serum vaspin level in relation to postprandial plasma glucose concentration in subjects with diabetes, Chin Med J (Engl) 2009;122(21): 2530–3.
• 7-Feng R, Li Y, Wang C, Luo C, Liu L, Chuo F, Higher vaspin levels in subjects with obesity and type 2 diabetes mellitus: a meta-analysis, Diabetes Res Clin Pract 2014;106(1):88–94.
• 8- Gülçelik N.E, Karakaya J, Gedik A, Serum vaspin levels in type 2 diabetic women in relation to microvascular complications, European Journal of Endocrinology 2009; 160: 65–70.
• 9-Sianos G, Morel MA, Kappetein AP, The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease, Euro Intervention. 2005 Aug;1(2):219-27.
• 10-Zhang, B., Peng, W., Wang, K., Li, H., & Xu, Y, Vaspin as a Prognostic Marker in Patients with Acute Myocardial Infarction. Heart, Lung, and Circulation,2016, 25(3), 257–264.
• 11.Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005; 96: 939–949.
• 12- Li HL, Peng WH, Cui ST, Lei H, Wei YD, Li WM, Xu YW, Vaspin plasma concentrations and mRNA expressions in patients with stable and unstable angina pectoris, Clin Chem Lab Med. 2011 Sep; 49(9):1547-54.
• 13.Aust G, Richter O, Rohm S, et al. Vaspin serum concentrations in patients with carotid stenosis. Atherosclerosis 2009; 204(1): 262-6. 14.Kadoglou NP, Gkontopoulos A, Kapelouzou A, Serum levels of vaspin and visfatin in patients with coronary artery disease-Kozani study, Clin Chim Acta. 2011; 412: 48-52.
• 15. Kobat MA, Celik A, Balin M, Altas Y, Baydas A, Bulut M, The investigation of serum vaspin level in atherosclerotic coronary artery disease. J Clin Med Res. 2012 Apr;4(2):110-3
• 16. Zhang B, Peng W, Li H, Lu Y, Zhuang J, Wang K, Plasma vaspin concentrations are decreased in acute coronary syndrome, but unchanged in patients without coronary lesions, Clin Biochem. 2013 Oct;46(15):1520-5.
• 17. Sathyaseelan AJ, Adole PS, Wyawahare M, Saya RP, Assessment of serum vaspin levels among Type 2 Diabetes Mellitus patients with or without Acute Coronary Syndrome, J Clin Diagn Res. 2016 Dec;10(12):07-10.
• 18. Hao F, Zhang H, Zhu J, Kuang H, Yu Q, Bai M, Mu J. Association between vaspin level and coronary artery disease in patients with type 2 diabetes. Diabetes Res Clin Pract. 2016 ;113:26-32.
• 19.Xiang Z, Yuqi C, Yifei T, Wei Z, Weiting X, Xiang L, Serum Vaspin as a Predictor of Adverse Cardiac Events in Acute Myocardial Infarction, J Am Heart Assoc. 2019 Jan 22; 8(2).
• 20.Ji S, Kou W, Luan P., Jian W, Zhuang J., Xu X., Plasma vaspin is an effective biomarker for evaluation of future cardiovascular events in patients with chest pain: a 5-year retrospective observational study, Annals of Translational Medicine,2020 April,8(7)