Nesfatin-1, a novel adipokine and dipeptidyl peptidase-4 (DPP4), a mam malian serine protease, are potent factors of atherosclerosis. In the present cross-sectional study, we investigated whether the plasma nesfatin-1 and DPP4 is associated with the prevalence and severity of coronary artery disease (CAD) with and without diabetes mellitus (DM). We consecutively enrolled a total of 240 patients with significant CAD (previous revascularization or angiographically-proven coronary artery stenosis > 50%) presented with either unstable angina (UA, N = 76) or stable chronic CAD (SCAD, N = 165). 85 patients with at least 2 classical cardiovascular risk factors but without significant CAD served as controls. The severity of CAD was assessed using coronary angiography by the Gensini score. Clinical parameters, glycemic and lipid profile, high-sensitivity CRP (hsCRP), nesfatin-1 and DPP4 levels were assayed. No differences were found for age, sex, hypertension and diabetes distribution between groups. Low nesfatin-1 levels were found in both CAD groups (UA & SCAD) with respect to controls. The difference between UA and SCAD groups was marginally non-significant. There was a significant increase of DPP4 along UA to SCAD and control groups. Differences between groups remained unchanged in non-diabetic participants. Nesfatin-1 significantly correlated to hsCRP (r = − 0.287, p = 0.036), HOMA-IR (r = − 0.587, p = 0.007) and hyperlipidemia (r = − 0.331, p = 0.034). DPP4 was significantly associated with hs-CRP (r = 0.353 p < 0.001) and FPG (r = 0.202, p = 0.020) in univariate analysis, but those correlations were lost in multiple regression analysis. There was a negative correlation between nesfatin-1 and the severity of CAD, quantified by the Gensini score (r = − 0.511, p < 0.001), but no association was found for DPP4. Serum DPP4 levels are increased in patients with CAD, while serum nesfatin-1 levels have a negative association with both the incidence and the severity of CAD. These results are independent of the presence of diabetes mellitus. In addition, both peptides have a strong association with hsCRP. Trial registration ClinicalTrials.gov Identifier: NCT00306176

中文翻译：

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冠状动脉疾病患者的血浆 nesfatin-1 和 DDP-4 水平：Kozani 研究

Nesfatin-1 是一种新型脂肪因子和二肽基肽酶 4 (DPP4)，一种哺乳动物丝氨酸蛋白酶，是动脉粥样硬化的有效因素。在目前的横断面研究中，我们调查了血浆 nesfatin-1 和 DPP4 是否与冠状动脉疾病 (CAD) 的患病率和严重程度相关，无论是否患有糖尿病 (DM)。我们连续招募了总共 240 名患有严重 CAD（既往血运重建或血管造影证实的冠状动脉狭窄 > 50%）的患者，这些患者表现为不稳定型心绞痛（UA，N = 76）或稳定的慢性 CAD（SCAD，N = 165）。85 名具有至少 2 个经典心血管危险因素但没有明显 CAD 的患者作为对照。CAD 的严重程度通过冠状动脉造影通过 Gensini 评分进行评估。临床参数、血糖和血脂特征，测定了高敏 CRP (hsCRP)、nesfatin-1 和 DPP4 水平。组间年龄、性别、高血压和糖尿病分布没有差异。与对照组相比，在两个 CAD 组（UA 和 SCAD）中都发现了低 nesfatin-1 水平。UA 和 SCAD 组之间的差异几乎不显着。沿 UA 到 SCAD 和对照组的 DPP4 显着增加。非糖尿病参与者的组间差异保持不变。Nesfatin-1 与 hsCRP (r = − 0.287, p = 0.036)、HOMA-IR (r = − 0.587, p = 0.007) 和高脂血症 (r = − 0.331, p = 0.034) 显着相关。在单变量分析中，DPP4 与 hs-CRP (r = 0.353 p < 0.001) 和 FPG (r = 0.202, p = 0.020) 显着相关，但在多元回归分析中这些相关性消失了。nesfatin-1 与 CAD 的严重程度呈负相关，由 Gensini 评分量化（r = - 0.511，p < 0.001），但未发现 DPP4 相关。CAD 患者的血清 DPP4 水平升高，而血清 nesfatin-1 水平与 CAD 的发病率和严重程度呈负相关。这些结果与糖尿病的存在无关。此外，这两种肽都与 hsCRP 有很强的关联。试验注册 ClinicalTrials.gov 标识符：NCT00306176 这些结果与糖尿病的存在无关。此外，这两种肽都与 hsCRP 有很强的关联。试验注册 ClinicalTrials.gov 标识符：NCT00306176 这些结果与糖尿病的存在无关。此外，这两种肽都与 hsCRP 有很强的关联。试验注册 ClinicalTrials.gov 标识符：NCT00306176