Correlation Between Serum FGF21 And Chemerin In Unstable Angina Pectoris Complicated With Essential Hypertension

Objective:To investigate the expression levels of serum fibroblast growth factor21(FGF21)and Chemerin in unstable angina pectoris(UA)complicated with essential hypertension(EH)and the correlation between the severity of the disease.methods:Patients who were hospitalized in the Department of Cardiology of our hospital and met the inclusion and exclusion criteria from August 2019 to September 2020 were included.UA combined with EH were included in the UA+EH group(n=50),Simple UA were included in the UA group(n=50),and Simple EH were included in the EH group(n=50).In addition,underwent physical examination at the same time were selected as the control group(n=50).The general information of patients and the differences of serum FGF21 and Chemerin levels among different groups were compared,and the correlation between serum FGF21 and Chemerin and coronary Gensini score in the UA+EH group was analyzed.According to the number of lesion branches,the UA+EH group was divided into a single-vessel lesion group,a two-vessel lesion group,and a three-vessel lesion group.the coronary Gensini score,serum FGF21 and Chemerin levels were compared among the subgroups.Multivariate Logistic regression model was used to evaluate the effects of FGF21 and Chemerin on UA+EH,EH and UA,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of UA+EH.Results:1.Basic data: Compared with the control group,the levels of TG and LDL-C were higher in UA+EH group,EH group and UA group,but the levels of HDL-C were lower.The smoking rate of UA+EH group and UA group was higher than that of control group.BMI of UA+EH group and EH group was higher than that of UA group and control group.LVEF in UA+EH group was lower than that in EH group,UA group and control group.(all P<0.05).2.Serum FGF21 and Chemerin levels in four groups:2.1 Compared with the control group,the levels of FGF21[159.5(153.6,168.4)、 146.5(132.5,157.5)、 135.7(131.4,148.7)vs123.7(120.3,125.8)] in UA+EH group,EH group and UA group were higher;Compared with EH group,the levels of FGF21[159.5(153.6,168.4)vs 146.5(132.5,157.5)]in UA+EH group were higher.Compared with UA group,the levels of FGF21[159.5(153.6,168.4)vs 135.7(131.4,148.7)]in UA+EH group were higher(all P<0.05).2.2 Compared with the control group,the levels of Chemerin[544.2(513.4,578.4)、 514.0(478.2,534.7)、 493.7(475.2,513.8)vs453.7(416.8,489.7)]in UA+EH group,EH group and UA group were higher;Compared with EH group,the levels of Chemerin [544.2(513.4,578.4)vs514.0(478.2,534.7)]in UA+EH group were higher.Compared with UA group,the levels of Chemerin [544.2(513.4,578.4)vs493.7(475.2,513.8)]in UA+EH group were higher(all P<0.05).3.Correlation between FGF21,Chemerin and Gensini score in patients with EH+UA: Spearman rank correlation analysis showed that FGF21,Chemerin were positively correlated with Gensini score in patients with UA+EH(r=0.757,0.736,all P < 0.05).4.Gensini score,FGF21,Chemerin level in different pathological subgroups of UA+EH patients: FGF21,Chemerin level and Gensini score in UA+EH patients increased with the increase of coronary artery lesion count(all P <0.05).5.Analysis of influencing factors of UA+EH,EH,UA: The relationship between FGF21,Chemerin and diseases was analyzed by taking disease types as dependent variables,FGF21,Chemerinage,sex,smoking history,BMI,LVEF,TG,LDL-C,HDL-C,AST,CRE,taking antihypertensive,lipid-lowering and antiplatelet drugs as independent variables.The result of multiple Logistic regression analysis showed that FGF21 and Chemerin are the influencing factors of UA+EH,EH,UA without correcting any factors(Model 1);After adjusting for age,sex,smoking history,BMI and LVEF(Model 2),FGF21 and Chemerin are the influencing factors of UA+EH,EH and UA.After adjusting TG,LDL-C,HDL-C,AST and CRE(Model 3)on the basis of Model 2,FGF21 is still the influencing factor of UA+EH,EH and UA,but Chemerin is the influencing factor of UA+EH and EH,not UA.On the basis of model 3,after further correcting the use of antihypertensive,lipid-lowering and antiplatelet drugs(model 4),FGF21 is an independent predictor of UA+EH,EH and UA,while Chemerin is only an independent predictor of UA+EH,but not an influencing factor of EH and UA(P<0.05).6.Diagnostic value of FGF21 and Chemerin for UA+EH: The AUC of FGF21 and Chemerin for UA+EH are 0.845 and 0.753.The Jordan index is 0.653 and 0.507.According to the maximum Jordan index,the best cutoff values of FGF21 and Chemerin in diagnosing UA+EH were151.75ng/L and 531.80ng/L,with sensitivity of 88.0% and 70.0%,and specificity of 77.3% and 80.7%.Conclusions:1.Serum FGF21 and Chemerin levels in patients with UA+EH are significantly increased;2.Serum FGF21 and Chemerin have a positive correlation with the severity of coronary lesions in patients with UA+EH;3.Serum FGF21 and Chemerin are independent predictors of the onset of UA+EH,and can be used as biomarkers to assist the clinical diagnosis and condition evaluation of UA+EH.