Clinical Study On Relationship Of Plasma Resistin Levels And Atrial Fibrillation

Objective: To detect plasma resistin levels in patients with lone atrial fibrillation (LAF).Explore whether plasma resistin is related with the incidence of AF and thepreservance of AF. Meanwhile, analyze the impact of hypertension and other factorson resistin.Methods: The patients with palpitations or chest tightness were enrolled in the study,they come from the Department of Cardiology, the First Affiliated Hospital of DalianMedical University, from June2012to December2012. The patients were140cases(aged from40-69years old, mean age54.45±6.10years old,72males,68females),divided in normal control group of25patients (aged from40-68years old,mean age55.28±7.28years old,12males and13females), who tested were healthypeople. According to the resting ECG or Holter ECG diagnosed of atrial fibrillationwere115patients(aged from40-69years old, mean age54.45±5.94years old,60males,55females).In which60patients were divided in LAF group(aged from41-59years old, mean age53.42±5.00years old,32males,28females), and the rest wereAF complicating with hypertension(aged from40-69years old, mean age55.50±6.67years old,28males and27females). The LAF group was further divided inparoxysmal AF group (30patients) and persistent AF group (30patients).All patients were excluded from the severe hyperlipidemia;liver and kidneyinsufficiency; rheumatic heart disease; primary cardiomyopathy; hyperthyroidism;various tumor diseases; history of major surgery within3months; acute infection (4 weeks);diabetes; obesity; corticosteroids for treatment of connective tissue disease; theoral thiazolidinedione patients and patients with secondary hypertension.Plasma resistin levels were examined in fasting venous blood by enzyme-linkedimmunosorbent assay （ELISA）. The blood lipid, fasting blood glucose, white bloodcell count and hypersensitive C-reactive protein were examined at the same time. Leftatrial diameter、left ventricular end-diastolic diameter and left ventricular ejectionfraction were measured by echocardiography.Results:(1) LAD: Persistent AF group was larger than normal control group (36.6±3.13vs33.08±2.08mm, P <0.01) and paroxysmal AF group (vs35.07±3.10mm, P<0.05). Paroxysmal AF group was larger than normal control group (35.07±3.10vs33.08±2.08mm, P <0.05).(2) hs-CRP levels:Persistent AF group was higher thannormal control group (2.20±1.20vs0.93±0.56mg/L, P <0.01)and paroxysmal AFgroup(vs1.56±0.98mg/L, P <0.05).Paroxysmal AF group was higher than normalcontrol group(1.56±0.98vs0.93±0.56mg/L, P <0.05).Meanwhile, AFcomplicating with hypertension group was higher than normal control group (4.50±2.94vs0.93±0.56mg/L, P <0.01)and LAF group(vs1.88±1.13mg/L,P<0.01).(3)Plasma resistin levels: Persistent AF group was higher than normal control group(13.45±6.83vs7.45±1.15ng/ml, P <0.01) and paroxysmal AF group(vs10.65±5.61ng/ml, P <0.05).Paroxysmal AF group was higher than normal control group(10.65±5.61vs7.45±1.15ng/ml, P <0.05). Meanwhile, AF complicating withhypertension group was higher than normal control group (15.13±8.57vs7.45±1.15ng/ml, P <0.01) and LAF group (vs12.05±6.35ng/ml, P <0.05).(4) Pearsoncorrelation analysis showed that plasma resistin levels were positively correlated withSBP (r=0.364, P=0.000), LAD (r=0.265, P=0.004) and hs-CRP (r=0.530, P=0.000). Multiple linear regression analysis demonstrated that plasma resistin levels hada linear relation with SBP and hs-CRP. The Linear equation：Y=-2.172+0.089SBP+1.347hs-CRP (R2=0.307, P <0.05).(5) Logistic regression analysis showed thatplasma resistin, hs-CRP entered into the regression equation, and their OR>1.Conclusion:(1) Plasma resistin levels were significantly higher in LAF group than normal control group, and persistent AF group compared with paroxysmal atrialfibrillation group increased, which suggests that resistin participate in the incidenceand preservance of AF.(2) Plasma resistin levels were higher in overall AF groups, and appeared superimposedon an upward trend,which suggests that resistin has the value of expression of these twopathological phenomena independently and it may affect the incidence of AF by riskfactors of AF (such as hypertension).(3) Plasma resistin levels were positively correlated with hs-CRP levels,which indicatesthat resistin may reflect the inflammatory state of AF, and it may prove the relationshipbetween the incidence and development of AF and the inflammation of atrium togetherwith other inflammatory factors.