Orosomucoid as prognosis factor associated with inflammation in acute or nutritional status in chronic heart failure
Orosomucoid as prognosis factor associated with inflammation in acute or nutritional status in chronic heart failure
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DOI：
10.1016/j.ijcard.2016.11.134
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发表时间：
2017-02-01
影响因子：
3.5
通讯作者：
Eiras, Sonia
中科院分区：
文献类型：
--
作者：
Agra, Rosa M.;Varela-Roman, Alfonso;Eiras, Sonia
背景：炎症和营养状态参与心力衰竭（HF）的发病机制。目的：研究α-1-酸性糖蛋白（AGP）对这些因素的贡献及其在急性（AHF）或慢性HF（CHF）中的预后价值。方法：观察性研究包括147例因HF入住心脏科的患者（平均年龄70岁，62%男性），平均随访326.6 +/- 140.8天。通过酶联免疫吸附试验测量血液AGP值。用流式细胞仪检测外周血单核细胞亚群，用双能X线吸收法测定体成分。结果：AHF患者出院时AGP、CD 14（+）CD 16（+）单核细胞和proBNP水平升高是再住院的指标。然而，较低的AGP水平决定了CHF患者更差的营养状态。心外膜脂肪中高浓度的AGP可下调瘦素水平。结论：AGP是心力衰竭的双重指标，因为高水平是AHF不良结局的预测因子，但低水平与CHF不良营养状况有关。AGP对心外膜脂肪中瘦素的调节可能为CHF的保护机制提供了新的途径。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background: Inflammation and nutritional state are involved in the pathogenesis of heart failure (HF). Objective: To study the contribution of alpha-1-acid-glycoprotein (AGP) to these factors and its prognostic value in acute (AHF) or chronic HF (CHF).Methods: The observational study has included 147 patients (mean age 70 years, 62% men) admitted to a cardiology department for HF and followed-up for an average 326.6 +/- 140.8 days. Blood AGP values were measured by Enzyme-Linked ImmunoSorbent Assay. Monocytes subsetswere determinedwith CD14 and CD16 antibodies by flowcytometry and body composition was measured by dual-energy X-ray absorptiometry. The regulation of tumor necrosis factor (TNF-alpha) and leptin by AGP in epicardial adipose tissue (EAT) were analyzed by real time polymerase chain reaction.Results: High AGP, that was associated with CD14(+) CD16(+) monocytes, and proBNP levels at the discharge were indicators of rehospitalization for HF in AHF patients. However, low AGP levels determined a worse nutritional state in CHF patients. The leptin levels were downregulated by high AGP concentration in epicardial fat.Conclusion: AGP is a dual indicator in HF because high levels are predictors of adverse outcomes in AHF but low levels are related to the worse nutritional status in CHF. The regulation of leptin by AGP in epicardial fat might suggest a new pathway as protective mechanism in CHF. (C) 2016 Elsevier Ireland Ltd. All rights reserved.