摘要
Abstract
Objective To investigate the predictive value of serum sclerostin and osteoprotegerin(OPG)/tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)ratio for major adverse cardiovascular events(MACE)in hypertensive patients with chronic heart failure(CHF).Methods A total of 134 patients with hypertension and CHF who were treated in this hospital from October 2019 to October 2022 were selected as the research objects.According to whether MACE occurred within 1 year of treatment,the patients were di-vided into MACE group(46 cases)and non-MACE group(88 cases).In addition,74 healthy people who un-derwent physical examination in the hospital during the same period were selected as the control group.The serum levels of sclerostin,OPG and TRAIL in the three groups were detected by enzyme-linked immunosor-bent assay.The clinical data(including history of coronary heart disease,diabetes,systolic blood pressure,di-astolic blood pressure)of patients were collected.The levels of serum total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),tumor nec-rosis factor-α(TNF-α),interleukin(IL)-6 and IL-10 were detected in the three groups.Pearson correlation a-nalysis was used to analyze the relationship between serum sclerostin,OPG and TRAIL levels and related la-boratory indicators in hypertensive patients with CHF.Multivariate Logistic regression was used to analyze the risk factors of MACE in hypertensive patients with CHF.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum sclerostin,OPG/TRAIL ratio alone and the com-bined detection of the two indexes for MACE.Results The levels of serum sclerostin,OPG and OPG/TRAIL ratio in the non-MACE group and the MACE group were significantly higher than those in the control group(P＜0.05),and the level of TRAIL was significantly lower than that in the control group(P＜0.05).The levels of serum sclerostin,OPG and OPG/TRAIL ratio in MACE group were significantly higher than those in non-MACE group(P＜0.05),and the level of TRAIL was significantly lower than that in non-MACE group(P＜0.05).The levels of TNF-α,IL-10 and IL-6 in the MACE group were higher than those in the non-MACE group,and the differences were statistically significant(P＜0.05).There were no significant differ-ences in the preportions of patients with history of coronary heart disease and diabetes,systolic blood pres-sure,diastolic blood pressure,and levels of TC,TG,HDL-C,and LDL-C between the the MACE group and the non-MACE group(P＞0.05).The serum levels of sclerostin and OPG were positively correlated with the lev-els of TNF-α,IL-10 and IL-6 in hypertensive patients with CHF(P＜0.05),and TRAIL was negatively corre-lated with the levels of TNF-α,IL-10 and IL-6(P＜0.05).Multiariable Logistic regression analysis results showed that elevated OPG and bone sclerosis protein levels were risk factors for hypertension patients with CHF with occurred MACE(P＜0.05),increased TRAIL level was protective factor for pressure patients with CHF with MACE protection factor(P＜0.05).The area under the curve(AUC)of serum sclerosing protein,OPG/TRAIL ratio alone and the combination of the two indicators for predicting MACE in hypertensive pa-tients with CHF were 0.847,0.803 and 0.927 respectively.The AUC of the combined detection of the two in-dicators was better than that of serum sclerostin or OPG/TRAIL ratio alone(Z=2.350,2.824,P＜0.05).Conclusion The combination of serum sclerostin and OPG/TRAIL ratio has a high predictive value for MACE in patients with hypertension and CHF.关键词
骨硬化蛋白/骨保护素/肿瘤坏死因子相关凋亡诱导配体/高血压伴慢性心力衰竭/主要不良心血管事件/预测价值Key words
sclerostin/osteoprotegerin/tumor necrosis factor-related apoptosis-inducing ligand/hy-pertension with chronic heart failure/major adverse cardiovascular events/predictive value分类
临床医学
