Abstract:

Objective　To analyze the relationships between fibroblast growth factor 21 (FGF21) and insulin-like growth factor 1 (IGF-1) levels and coronary atherosclerosis in elderly patients with coronary heart disease (CHD). Methods　Retrospective analysis was made on the clinical data of 96 CHD patients who were treated in Jinan Second People's Hospital from January 2020 to December 2021, including 54 males and 42 females, aged (72.24±8.93) years, 46 cases of mild sclerosis, 28 cases of moderate sclerosis, and 22 cases of severe sclerosis. Another 60 healthy people who were examined in the physical examination center of Jinan Second People's Hospital during the same period were selected as the control group, including 36 males and 24 females, aged (70.43±8.56) years. The relationships between serum FGF21 and IGF-1 levels and coronary atherosclerosis were analyzed. F test, independent sample t test, χ² test, receiver operating characteristic curve (ROC) analysis, multiple logistic regression analysis, and Spearman rank correlation analysis were used. Results　The level of FGF21 in the severe sclerosis group was higher than that in the moderate sclerosis group, the level of FGF21 in the moderate sclerosis group was higher than that in the mild sclerosis group, the level of IGF-1 in the severe sclerosis group was lower than that in the moderate sclerosis group, and the level of IGF-1 in the moderate sclerosis group was lower than that in the mild sclerosis group (all P<0.05). The serum level of FGF21 in the CHD patients was higher than that in the control group, and the level of IGF-1 was lower than that in the control group (both P<0.05). The ROC analysis proved that serum FGF21 and IGF-1 levels could be used in clinical evaluation of CHD, with the areas under the curve of 0.794 and 0.813, respectively, both P<0.05. Multivariate logistic regression analysis showed that FGF21≥590.68 ng/L and IGF-1≤82.67 µg/L were risk factors for CHD [both odds ratio (OR) >1, P<0.05]. Correlation analysis showed that serum FGF21 level was positively correlated with the degree of coronary atherosclerosis (r=0.753, P<0.05), and IGF-1 was negatively correlated with the degree of coronary atherosclerosis (r=-0.712, P<0.05). Conclusions　Both elevated serum FGF21 and reduced IGF-1 are related to the severity of coronary atherosclerosis. Clinically, FGF21≥590.68 ng/L and IGF-1≤82.67 µg/L can be used as biological indicators for clinical diagnosis of CHD in the elderly, providing references for clinical evaluation and treatment of the disease.

Key words:

Coronary heart disease, Fibroblast growth factor 21, Insulin-like growth factor-1, Coronary atherosclerosis,  , Correlation

摘要：

目的　分析老年冠心病患者成纤维细胞生长因子21（FGF21）、胰岛素样生长因子-1（IGF-1）水平与冠状动脉粥样硬化的关系。方法　回顾性分析2020年1月至2021年12月于济南市第二人民医院进行治疗的96例冠心病患者的临床资料，男54例，女42例，年龄（72.24±8.93）岁；轻度硬化46例，中度硬化28例，重度硬化22例。另选同期于济南市第二人民医院体检中心体检的健康者60例设为对照组，男36例，女24例，年龄（70.43±8.56）岁。分析血清FGF21、IGF-1水平与冠状动脉粥样硬化的关系。采用F检验、独立样本t检验、χ²检验、受试者工作特征曲线（ROC）分析、多因素logistic回归分析、Spearman秩相关分析。结果　重度硬化组FGF21水平高于中度硬化组，中度硬化组FGF21水平高于轻度硬化组，重度硬化组IGF-1水平低于中度硬化组，中度硬化组IGF-1水平低于轻度硬化组（均P<0.05）；冠心病患者的血清FGF21水平高于对照组，IGF-1水平低于对照组（均P<0.05）。经受试者工作特征曲线（ROC）分析证实血清FGF21、IGF-1水平均可用于冠心病的临床评估中，曲线下面积分别为0.794、0.813，均P<0.05。多因素logistic回归分析显示，FGF21≥590.68 ng/L、IGF-1≤82.67 µg/L是冠心病的危险因素［均比值比（OR）>1，P<0.05］。相关性分析显示，血清FGF21水平与冠状动脉粥样硬化程度呈正相关（r=0.753，P<0.05），IGF-1与冠状动脉粥样硬化程度呈负相关（r=-0.712，P<0.05）。结论　血清FGF21升高、IGF-1降低均与冠状动脉粥样硬化严重程度相关，临床可将FGF21≥590.68 ng/L、IGF-1≤82.67 µg/L作为临床诊断老年冠心病的生物学指标，为临床病情评估和治疗提供参考。

关键词:

冠心病, 成纤维细胞生长因子21, 胰岛素样生长因子-1, 冠状动脉粥样硬化, 相关性