目的 探究老年冠心病（CHD）患者血清网膜素-1（omentin-1）、趋化素（chemerin）水平与主要心血管不良事件（MACE）风险的关系。 方法 选取2023年1月至2025年1月唐山市工人医院心血管内科收治的313例老年CHD患者作为研究对象，排除失访患者13例，最终纳入300例患者，根据患者MACE发生情况分为MACE组与无MACE组，统计并分析两组患者基线资料、临床资料及血清omentin-1、chemerin水平。采用Spearman相关性分析探究老年CHD患者血清omentin-1、chemerin水平与MACE风险的关系。采用LASSO回归与多因素logistic回归探究老年CHD患者MACE发生的危险因素，基于多因素logistic回归分析结果构建列线图预测模型，通过校准曲线、受试者工作特征（ROC）曲线进行内部验证，采用临床决策曲线评估模型临床实用性。 结果 随访期间共97例（32.33%）患者发生MACE（MACE组），其余203例（67.67%）患者未发生MACE（无MACE组）。MACE组血清omentin-1水平低于无MACE组、chemerin水平高于无MACE组（P < 0.05）。Spearman相关性分析结果显示老年CHD患者MACE发生情况与血清omentin-1水平呈负相关（r = -0.637，P < 0.001），与血清chemerin水平呈正相关（r = 0.552，P < 0.001）。多因素logistic回归分析结果显示omentin-1（95%CI：0.992 ~ 0.997）、chemerin（95%CI：1.012 ~ 1.058）、Gensini积分（95%CI：1.012 ~ 1.165）、CRP（95%CI：1.711 ~ 3.627）、LVEF（95%CI：0.756 ~ 0.895）为老年CHD患者MACE发生的影响因素（P < 0.05）。ROC曲线分析显示omentin-1、chemerin单独预测老年CHD患者MACE发生的曲线下面积值（AUC）分别为0.893（95%CI：0.852 ~ 0.926）、0.841（95%CI：0.794 ~ 0.880）。基于多因素logistic回归分析结果构建的列线图模型预测老年CHD患者发生MACE的AUC为0.979（95%CI：0.956 ~ 0.992）；校准曲线显示预测曲线与理想曲线贴合良好，模型校准度较好；临床决策曲线显示，当风险阈值概率为0.01 ~ 0.99时，该模型可产生更好的临床效益。 结论 omentin-1、chemerin与老年CHD患者MACE的发生存在密切关联且具有良好的预测价值。基于omentin-1、chemerin等指标构建的列线图模型预测效能良好，可为临床评估老年CHD患者MACE发生风险提供参考。

Objective To explore the association between serum omentin-1 and chemerin levels and the risk of major adverse cardiovascular events （MACE） in elderly patients with coronary heart disease （CHD）. Methods A total of 313 elderly patients with coronary heart disease （CHD） admitted to the Department of Cardiology， Tangshan Workers' Hospital between January 2023 and January 2025 were recruited as study subjects. After excluding 13 patients who were lost to follow-up， 300 patients were ultimately included in the study. The patients were then classified into the major adverse cardiovascular events （MACE） group and the non-MACE group according to the occurrence of MACE. Baseline data， clinical data， and serum levels of omentin-1 and chemerin in the two groups were statistically analyzed. Spearman correlation analysis was employed to investigate the association between serum omentin-1 and chemerin levels and the risk of MACE in elderly CHD patients. LASSO regression and multivariate logistic regression were utilized to identify the risk factors for MACE in elderly CHD patients. Based on the results of multivariate logistic regression analysis， a nomogram prediction model was developed and internally validated using the calibration curve and receiver operating characteristic （ROC） curve. The clinical utility of the model was assessed through decision curve analysis. Results During the follow-up period， 97 patients （32.33%） experienced Major Adverse Cardiovascular Events （MACE） （MACE group）， whereas the remaining 203 patients （67.67%） did not （non-MACE group）. The MACE group exhibited lower serum omentin-1 levels and higher chemerin levels compared to the non-MACE group （P < 0.05）. The results of Spearman correlation analysis indicated that the occurrence of MACE was negatively correlated with the serum omentin-1 level （r = -0.637， P < 0.001） and positively correlated with the serum chemerin level （r = 0.552， P < 0.001） among elderly patients with Coronary Heart Disease （CHD）. Multivariate logistic regression analysis demonstrated that omentin-1 （95%CI： 0.992 ~ 0.997）， chemerin （95%CI： 1.012 ~ 1.058）， Gensini score （95%CI： 1.012 ~ 1.165）， C-reactive protein （CRP） （95%CI： 1.711 ~ 3.627）， and Left Ventricular Ejection Fraction （LVEF） （95%CI： 0.756 ~ 0.895） were influencing factors for MACE in elderly CHD patients （P < 0.05）. ROC curve analysis revealed that the areas under the curve （AUCs） of omentin - 1 and chemerin for predicting MACE in elderly CHD patients were 0.893 （95%CI： 0.852 ~ 0.926） and 0.841 （95%CI： 0.794 ~ 0.880）， respectively. The AUC of the nomogram model constructed based on the results of multivariate logistic regression analysis for predicting MACE in elderly CHD patients was 0.979 （95%CI： 0.956 ~ 0.992）. The calibration curve showed a good agreement between the predicted curve and the ideal curve， suggesting good model calibration. Decision curve analysis indicated that when the risk threshold probability ranged from 0.01 to 0.99， the model could yield better clinical benefits. Conclusions Omentin-1 and chemerin are intricately associated with the occurrence of Major Adverse Cardiovascular Events （MACE） in elderly patients with Coronary Heart Disease （CHD） and possess excellent predictive value. The nomogram model constructed based on indicators such as omentin-1 and chemerin exhibits superior predictive performance and can offer a reference for the clinical assessment of the risk of MACE in elderly patients with CHD.