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心外膜脂肪组织及炎症因子与房颤的相关性研究
Association of epicardial adipose tissue and inflammatory factors with atrial fibrillation
- 重庆医科大学学报 2024年49卷第7期 页码：884-889
- 作者机构：
重庆医科大学附属第一医院心血管内科，重庆 400016
- 作者简介：
许润霞，Email：13618279906@163.com，研究方向：心血管内科、心律失常的研究和治疗。
肖 骅，Email：xiaohua197408@163.com。
- 基金信息：重庆市自然科学基金资助项目(CSTB2023NSCQ-MSX0491)
DOI：10.13406/j.cnki.cyxb.003551
中图分类号： R541.7+5收稿：2024-01-25，
修回：2024-04-04，
录用：2024-04-10，
纸质出版：2024-07-28
- 稿件说明：
移动端阅览
许润霞,史家欣,吴佳灿,等.心外膜脂肪组织及炎症因子与房颤的相关性研究[J].重庆医科大学学报,2024,49(7):884-889.
Xu Runxia,Shi Jiaxin,Wu Jiacan,et al.Association of epicardial adipose tissue and inflammatory factors with atrial fibrillation[J].Journal of Chongqing Medical University,2024,49(7):884-889.
许润霞,史家欣,吴佳灿,等.心外膜脂肪组织及炎症因子与房颤的相关性研究[J].重庆医科大学学报,2024,49(7):884-889. DOI： 10.13406/j.cnki.cyxb.003551.
Xu Runxia,Shi Jiaxin,Wu Jiacan,et al.Association of epicardial adipose tissue and inflammatory factors with atrial fibrillation[J].Journal of Chongqing Medical University,2024,49(7):884-889. DOI： 10.13406/j.cnki.cyxb.003551.
摘要
目的
2
探讨超声心动图测量的心外膜脂肪组织厚度（epicardial adipose tissue thickness，EATT）、循环中炎症因子水平与心房颤动（atrial fibrillation，AF，简称房颤）的相关性。
方法
2
选取重庆医科大学附属第一医院心血管内科的房颤患者共89例作为观察组，另外选取窦性心律患者21例作为对照组。所有患者通过超声心动图测量右室游离壁EATT，并收集一般资料、血生化指标、超声测量指标、合并症。经排除标准筛选后剩余50例房颤和20例对照，收集上述患者外周血清，用酶联免疫吸附法检测血清炎症因子水平。研究EATT、炎症因子与房颤的相关性。
结果
2
①EATT与房颤的相关性分析（房颤89例，对照21例）：房颤组年龄、血尿素氮（blood urea nitrogen，BUN）、血清肌酐（serum creatinine，Scr）、左房内径（left atrial diameter，LAD）、EATT明显大于对照组。房颤组总胆固醇（total cholesterol，TC）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、左心室射血分数（left ventricular ejection fraction，LVEF）明显低于对照组。多因素二元logistic回归分析发现年龄、Scr、LAD、EATT是房颤的独立危险因素。②EATT联合炎症因子与房颤的相关性分析（房颤50例，对照20例）：房颤患者EATT、循环中白细胞介素（interleukin，IL）-8、IL-10水平明显高于对照组。EATT、IL-8、IL-10预测房颤的受试者工作特征（receiver operating characteristic，ROC）曲线显示曲线下面积（area under the curve，AUC）分别为0.746、0.769、0.721。EATT、IL-8、IL-10联合预测房颤的ROC曲线显示AUC为0.826（95%CI=0.720~0.932，
P
=0.000），灵敏度和特异性分别为68%和90%。以IL-8=18.7 pg/mL为截断值分组，发现组间对比EATT无差异。以IL-10=5.886 pg/mL为截断值分组，发现IL-10≥5.886 pg/mL组EATT更大（
P
=0.022）。Spearman相关性分析显示房颤组EATT与肿瘤坏死因子（tumor necrosis factor，TNF）-α呈正相关（
r
s
=0.422，
P
=0.002）。
结论
2
EATT的增加与房颤密切相关，EATT是房颤的独立危险因素。房颤患者循环中IL-8、IL-10明显升高。EATT联合IL-8、IL-10对房颤的预测价值更高，有助于房颤的早发现、早诊断、早治疗。EATT在高IL-10亚组中明显升高，房颤组EATT与TNF-α呈正相关，这表明EAT可能是通过炎症相关作用参与房颤的发生发展。
Abstract
Objective
2
To investigate the association of epicardial adipose tissue thickness（EATT） measured by echocardiography and the circulating levels of inflammatory factors with atrial fibrillation（AF）.
Methods
2
A total of 89 patients with AF who were treated in Department of Cardiology，The First Affiliated Hospital of Chongqing Medical University，were enrolled as observation group，and 21 patients with sinus rhythm were enrolled as control group. All patients underwent echocardiography to measure EATT of the free wall of the right ventricle，and related data were collected，including general information，biochemical parameters，ultrasound measurements，and complications. Based on the exclusion criteria，there were finally 50 patients with AF and 20 controls. Peripheral serum was collected from these patients，and ELISA was used to measure the serum levels of inflammatory factors. The association of EATT and inflammatory factors with AF was analyzed.
Results
2
The association between EATT and AF was analyzed among 89 patients with AF and 21 controls，and the results showed that compared with the control group，the AF group had significantly higher age，blood urea nitrogen，serum creatinine（Scr），left atrial diameter（LAD），and EATT and significantly lower total cholesterol，low-density lipoprotein cholesterol，and left ventricular ejection fraction. The binary multivariate logistic regression analysis showed that age，Scr，LAD，and EATT were independent risk factors for AF. The association of EATT and inflammatory factors with AF was analyzed among 50 patients with AF and 20 controls，and the results showed that the AF group had si
gnificantly higher EATT and circulating levels of interleukin-8（IL-8） and interleukin-10（IL-10） than the control group. The receiver operating characteristic（ROC） curve analysis showed that EATT，IL-8，and IL-10 had an area under the ROC curve（AUC） of 0.746，0.769，and 0.721，respectively，in predicting AF，while the combination of EATT，IL-8，and IL-10 had an AUC of 0.826（95%CI=0.720-0.932，
P
=0.000） in predicting AF，with a sensitivity of 68% and a specificity of 90%. The patients were divided into groups based on the cut-off value of 18.7 pg/mL for IL-8，and there was no significant difference in EATT between groups；the patients were divided into groups based on the cut-off value of 5.886 pg/mL for IL-10，and the results showed that the IL-10≥5.886 pg/mL group tended to have a larger EATT（
P
=0.022）. The Spearman correlation analysis showed that EATT was positively correlated with tumor necrosis factor-α（TNF-α） in the AF group（
r
=0.422，
P
=0.002）.
Conclusion
2
The increase in EATT is closely associated with AF，and EATT is an independent risk factor for AF. There are significant increases in the circulating levels of IL-8 and IL-10 in patients with AF. EATT combined with IL-8 and IL-10 has a higher value in predicting AF and may help with the early identification，diagnosis，and treatment of AF. There is a significant increase in EATT in the high IL-10 subgroup，and EATT is positively correlated with TNF-α in the AF group，suggesting that EATT may be involved in the development and progression of AF through inflammatory effects.
关键词
Keywords
references
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