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Fatty acid binding protein 4(FABP4) is one of Fatty acid binding proteins family, first found in adipocytes and macrophages, which has been confirmed to be an important part in the development of insulin resistance and metabolic syndrome. Recent studies have indicated that it is involved in the inflammatory response and the formation of atherosclerotic plaque, which is even detected high expression in rupture plague. FABP4 can also be released into blood, which can be measured by elisa enzyme linked immunosorbent assay(ELISA). Recent studies have shown that high expression of FABP4 in plasma and plaque is associated with vulnerable plaque phenotype, associated with plaque associated symptoms and future adverse cardiovascular events. This research hypothesis the expression level of FABP4 in patients with acute coronary syndrome (i.e., coronary atherosclerotic plaque instability) was increased, and study its clinical significance to explore a new biomarker of acute coronary syndrome and plaque instability, in order to provide new ideas and theoretical basis for the prevention and treatment of acute coronary syndrome, and to guide clinical work.
39 patients who were in hospital in shanghai putuo hospital from January 1st 2015 to December 31st 2015 were involved, age from 47 to 91y .39 patients were grouped by symptom, physical sign and accessory examination: ACS group 20 examples (male 10, female 10, age 59-91 years-old, average 80.7 y) and control group 19 examples (male 8, female 11, age 47-84 y, average 69.4). Agreement were obtained from all of them. All of examples were extracted elbow vein blood 5 ml in peaceful. The blood were centrifugated under 2000 r/min for 10mins,then plasma above were kept in -80°C to be measured. The FABP4 was measured by ELISA. At the same time,examples’ clinical message were collected such as gender,age,systolic pressure,diastolic pressure, CRP, AST, ALT, BUN, creatinine, HbA1c, fasting blood-glucose, TG, TC, HDL, LDL, ApoE, ApoB, FF, TNI, CK-MBmass, myoglobin, CK, telegraphy（SV1+RV5）, left atrium ID, EF%. To compare two groups difference in plasma FABP4 and clinical messages.
Compared with the health group, the acute coronary syndrome in age (80 + 8 y), CRP (38.8 + 4.44), myocardial injury markers (TnI (13.6 ± 25.3ng/ml), CK-MB mass (29.9 ±38.2 ng / ml), myoglobin (10.68 ±8.98 ng / ml), myocardial enzyme (creatine kinase (405.1 ± 426.7 U / L), glycosylated hemoglobin (7.3±1.2) and FABP4 (40845 ± 26022.17pg/ml) were higher and ejection fraction (52±11) was decreased, lipid profile including triglyceride (TG) [1.3 ± 0.6mmol/l], total cholesterol (TC) [4.3 ± 1.2 mmol/l], high density lipoprotein (HDL) [1.1±0.3mmol/l], low density lipoprotein (LDL) [2.7 ± 0.9 mmol/l], carrying lipoprotein (apo) [ApoA (1.1 ±0.1g/l) and apolipoprotein E (40.6 ± 11.8mg/l) apo protein B (0.8 ± 0.2 g / L)], free fatty acid (FF) [0. 5 ± 0.2mmol/l] and fasting blood glucose (5.5 ± 3.2 mmol/l) had no difference in two group.
Acute coronary syndrome patients serum FABP4 levels increased, and this elevated FABP4 levels is independent of CRP, urea nitrogen, and has a similar role to TNI on the diagnosis of acute coronary syndrome. FABP4 levels in peripheral blood may be a new biomarker of plaque instability and acute coronary syndrome. Subgroup analysis showed that the plasma levels of FABP4 were significantly higher in female patients than in male, and the clinical significance of FABP4 in female patients was better than that of male patients was worth further study.