中青年急性心肌梗死患者血清IGFBP5、sOSCAR水平及其与冠状动脉狭窄程度和预后的关系OA

Objective To investigate the expression and clinical significance of serum insulin-like growth factor binding protein 5(IGFBP5)and soluble osteoclast-associated receptor(sOSCAR)in young and middle-aged patients with acute myocardial infarction(AMI).Methods A total of 105 young and middle-aged AMI patients admitted to the Department of Cardiology,Xingtai Central Hospital from January 2021 to June 2023 were prospectively selected as the AMI group.According to the degree of coronary stenosis(Gensini score),they were divided into mild stenosis(＜30 points,32 ca-ses),moderate stenosis(30-60 points,42 cases),and severe stenosis(＞60 points,31 cases).Additionally,60 healthy volunteers were selected as the healthy control group.The young and middle-aged AMI patients were further divided into poor and good prognosis subgroups based on their 24-month prognosis.Serum IGFBP5 and sOSCAR expression levels were detec-ted by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum IGFBP5,sOSCAR expression,and Gensini score.The relationship between serum IGFBP5 and sOSCAR expression and the prognosis of young and middle-aged AMI patients,as well as their predictive efficacy,were analyzed.Results Compared with the healthy control group,serum IGFBP5 expression was increased and sOSCAR expression was decreased in the AMI group(t/P=15.073/＜0.001,16.141/＜0.001).Serum IGFBP5 expression increased sequentially,and sOSCAR expression de-creased sequentially,across mild,moderate,and severe stenosis groups(F/P=268.737/＜0.001,87.294/＜0.001).In young and middle-aged AMI patients,Gensini score was positively correlated with serum IGFBP5 expression and negatively correlated with sOSCAR expression(r/P=0.745/＜0.001,-0.732/＜0.001).The 12-month poor prognosis rate among the 105 young and middle-aged AMI patients was 40.00％(42/105).Gensini score,Killip grade ≥ Ⅱ,and elevated IGFBP5 were independent risk factors for poor prognosis,while elevated sOSCAR was an independent protective factor[OR(95％CI)=3.636(1.518-8.710),2.754(1.141-6.647),1.013(1.005-1.021),0.987(0.987-0.997)].The AUCs of serum IGFBP5 expression,sOSCAR expression,and their combination for predicting poor prognosis in young and middle-aged AMI patients were 0.784,0.786,and 0.857,respectively.The combined prediction showed a larger AUC(Z/P=2.141/0.032,2.348/0.019).Conclusion Serum IGFBP5 expression is increased and sOSCAR expression is decreased in young and middle-aged AMI patients,which is close-ly related to the aggravation of coronary stenosis and poor prognosis.The combined detection of serum IGFBP5 and sOSCAR has higher predictive efficacy for poor prognosis in young and middle-aged AMI patients.