老年冠心病患者血清网膜素-1、趋化素水平与主要心血管不良事件风险的关系

doi:10.3969/j.issn.1006-5725.2026.01.013

Abstract

Abstract:

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.

Key words: coronary heart disease, elderly, major adverse cardiovascular events, omentin-1, chemerin

CLC Number:

R541.4

Na LI,Liying QIAO,Chuhao ZHEN. Association of serum omentin-1 and chemerin levels with the risk of major adverse cardiovascular events in elderly patients with coronary heart disease[J]. The Journal of Practical Medicine, 2026, 42(1): 101-109.

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指标	MACE组（n = 97）	无MACE组（n = 203）	t/χ²值	P值
年龄（x ± s）/岁	74.31 ± 4.03	73.58 ± 3.79	1.529	0.127
BMI（x ± s）/（kg/m²）	25.16 ± 2.22	24.73 ± 2.41	1.482	0.139
病程（x ± s）/年	5.03 ± 1.26	4.89 ± 1.40	0.836	0.404
性别			0.023	0.878
男	55（56.70）	117（57.64）
女	42（43.30）	86（42.36）
合并基础疾病			0.470	0.493
糖尿病	59（60.82）	115（56.65）
高脂血症	71（73.20）	155（76.35）	0.352	0.553
高血压	63（64.95）	121（59.61）	0.790	0.374
冠脉病变支数			10.049	0.002
单支	25（25.77）	91（44.83）
多支	72（74.23）	112（55.17）
病变血管			4.307	0.116
右冠脉	27（27.83）	37（18.23）
左前降支	41（42.27）	107（52.71）
左回旋支	29（29.90）	59（29.06）
Gensini积分（x ± s）/分	51.97 ± 9.05	47.35 ± 7.11	4.806	< 0.001
吸烟史	42（43.30）	81（39.90）	0.313	0.576
饮酒史	55（56.70）	96（47.29）	2.325	0.127

组别	例数	omentin-1/（ng/L）	Chemerin/（ng/L）
MACE组	97	654.42 ± 120.77	114.32 ± 29.28
无MACE组	203	1 008.53 ± 268.19	81.61 ± 20.03
t值		12.409	11.918
P值		< 0.001	< 0.001

指标	MACE组（n = 97）	无MACE组（n = 203）	t/χ²值	P值
实验室指标
Hb/（g/L）	127.38 ± 19.65	126.22 ± 21.03	0.456	0.649
WBC/（× 10⁹/L）	8.05 ± 1.72	7.93 ± 1.86	0.535	0.593
PLT/（×10⁹/L）	211.07 ± 22.68	209.23 ± 25.56	0.604	0.546
LDL-C/（mmol/L）	3.06 ± 0.65	2.97 ± 0.50	1.319	0.188
HDL-C/（mmol/L）	1.05 ± 0.50	1.11 ± 0.33	1.237	0.217
TC/（mmol/L）	5.23 ± 0.80	5.13 ± 0.85	0.971	0.332
D-D/（mg/L）	0.66 ± 0.10	0.64 ± 0.08	1.864	0.063
TG/（mmol/L）	1.65 ± 0.48	1.59 ± 0.50	0.985	0.326
CRP/（mg/L）	8.96 ± 1.96	6.18 ± 1.53	13.402	< 0.001
心功能指标
LVESD/mm	37.16 ± 5.60	36.68 ± 5.22	0.728	0.467
LVEDD/mm	54.06 ± 4.39	51.87 ± 5.63	3.371	0.001
LVEF/%	48.15 ± 7.29	57.43 ± 6.96	10.637	< 0.001
药物使用情况/［例（%）］
钙离子拮抗剂	20（20.62）	58（28.57）	2.158	0.142
氯吡格雷	87（89.69）	198（97.54）	8.507	0.004
他汀类	76（78.35）	162（79.80）	0.084	0.771
ACEI/ARB	89（91.75）	201（99.01）	10.743	0.001
β-受体阻滞剂	83（85.57）	195（96.06）	10.633	0.001
阿司匹林	90（92.78）	202（99.51）	11.433	0.001

变量	β	SE	Waldχ²	OR	95%CI	P值
omentin-1	-0.006	0.001	18.513	0.994	0.992 ~ 0.997	< 0.001
chemerin	0.034	0.011	9.333	1.035	1.012 ~ 1.058	0.002
Gensini积分	0.082	0.036	5.209	1.086	1.012 ~ 1.165	0.022
CRP	0.913	0.192	22.685	2.491	1.711 ~ 3.627	< 0.001
LVEDD	0.078	0.053	2.144	1.081	0.974 ~ 1.200	0.143
LVEF	-0.195	0.043	20.518	0.823	0.756 ~ 0.895	< 0.001
常量	-4.160	4.245	0.960	0.016		0.327

指标	AUC（95%CI）	Z值	P值	约登指数	临界值	敏感度/%	特异度/%
omentin-1	0.893（0.852 ~ 0.926）	21.173	< 0.001	0.707	827 ng/L	93.81	76.85
chemerin	0.841（0.794 ~ 0.880）	12.349	< 0.001	0.624	105 ng/L	73.20	89.16

Association of serum omentin-1 and chemerin levels with the risk of major adverse cardiovascular events in elderly patients with coronary heart disease

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