Huang Huiling, Mai Weiyi, Liu Dan, Hao Yuantao, Tao Jun, Dong Yugang
Department of Cardiology, the First Affiliated Hospital of Sun Yat Sen University, Guangzhou, PR China.
Dis Markers. 2008;24(6):341-9. doi: 10.1155/2008/371314.
Oxidized LDL cholesterol (ox-LDL-C) is considered to be a key factor of initiating and accelerating atherosclerosis (AS). The purpose of this study is to elucidate the sensitivity and specificity of ox-LDL and oxidation ratio of LDL in the diagnosis of coronary artery disease (CAD). For the first time, we investigated the ratio of ox-LDL to ALB(ox-LDL/ALB).
Blood ox-LDL, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and albumin (ALB) were measured in patients with acute myocardial infarction (AMI, n = 80), unstable angina pectoris (UAP, n = 80), stable angina pectoris (SAP, n = 80), normal control (n = 60), and dyslipidemia control (n = 60). Ox-LDL was measured by competitive ELISA. The level of ox-LDL and oxidation ratio of LDL(ox-LDL/TC, ox-LDL/HDL-C, ox-LDL/ LDL-C and ox-LDL/ALB) were significantly higher in each diseased group than controls (P < 0.001). In CAD group, ox-LDL and oxidation ratio of LDL in subjects complicated with hypertension (HT) and/or diabetes mellitus (DM) increased further (P < 0.001). Ox-LDL/ALB in the AMI group was 7 times higher than normal control group (0.068 +/- 0.017 vs 0.009 +/- 0.007, P < 0.001). The area under the curve (AUC) of receiver operating characteristic curve (ROC curve) is a criterium to evaluate the accuracy of diagnosing a disease. The AUC of ROC curve of ox-LDL/TC, ox-LDL/HDL-C, ox-LDL, ox-LDL/ALB and ox-LDL/ LDL-C for diagnosing CAD were 0.975, 0.975, 0.966, 0.966, 0.957 respectively (P < 0.001). When ox-LDL/TC = 0.175, the sensitivity and specificity of diagnosing CAD were 0.917 and 0.925, which were almost equal to each other, indicating that the rates of missed diagnosis and misdiagnosis for CAD were the lowest.
The level of ox-LDL and the ratio of ox-LDL/TC, ox-LDL/LDL-C, ox-LDL/HDL-C and ox-LDL/ALB are better biomarkers than TC, TG, HDL-C and LDL-C for discriminating between patients with coronary artery disease and healthy subjects. And patients who have a high ratio of ox-LDL /TC may have a higher risk for CAD.
氧化型低密度脂蛋白胆固醇（ox-LDL-C）被认为是引发和加速动脉粥样硬化（AS）的关键因素。本研究旨在阐明ox-LDL及LDL氧化率在冠心病（CAD）诊断中的敏感性和特异性。我们首次研究了ox-LDL与白蛋白的比值（ox-LDL/ALB）。
对急性心肌梗死患者（AMI，n = 80）、不稳定型心绞痛患者（UAP，n = 80）、稳定型心绞痛患者（SAP，n = 80）、正常对照组（n = 60）和血脂异常对照组（n = 60）测定血液中的ox-LDL、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）和白蛋白（ALB）。采用竞争ELISA法测定ox-LDL。各疾病组的ox-LDL水平及LDL氧化率（ox-LDL/TC、ox-LDL/HDL-C、ox-LDL/LDL-C和ox-LDL/ALB）均显著高于对照组（P < 0.001）。在CAD组中，合并高血压（HT）和/或糖尿病（DM）的患者ox-LDL及LDL氧化率进一步升高（P < 0.001）。AMI组的ox-LDL/ALB比正常对照组高7倍（0.068±0.017 vs 0.009±0.007，P < 0.001）。受试者工作特征曲线（ROC曲线）下的面积（AUC）是评估疾病诊断准确性的标准。ox-LDL/TC、ox-LDL/HDL-C、ox-LDL、ox-LDL/ALB和ox-LDL/LDL-C诊断CAD的ROC曲线AUC分别为0.975、0.975、0.966、0.966、0.957（P < 0.001）。当ox-LDL/TC = 0.175时，诊断CAD的敏感性和特异性分别为0.917和0.925，两者几乎相等，表明CAD的漏诊率和误诊率最低。
与TC、TG、HDL-C和LDL-C相比，ox-LDL水平及ox-LDL/TC、ox-LDL/LDL-C、ox-LDL/HDL-C和ox-LDL/ALB比值是区分冠心病患者和健康受试者的更好生物标志物。且ox-LDL/TC比值高的患者患CAD的风险可能更高。
