Key Laboratory of Clinical Trial Research in Cardiovascular Drug, Ministry of Health, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
Chin Med J (Engl). 2010 Mar 20;123(6):658-63.
High-density lipoprotein cholesterol (HDL-C) levels are a strong, independent inverse predictor of coronary heart disease (CHD). In this cross-sectional study we investigated the interrelationships between HDL-C and HDL related factors apolipoprotein A-I (apoA-I) and serum amyloid A (SAA) and the presence and extent of CHD in a population of Chinese patients with CHD.
Two hundred and twenty-four consecutive patients took part in this study. Demographic data were obtained from hospital records. Serum chemical concentrations were measured by standard laboratory methods.
The concentrations of high-sensitive C-reactive protein (hsCRP) (median: 1.85 mg/L) and SAA (median: 9.40 mg/L) were significantly higher in the CHD group (P < 0.05), while concentrations of HDL-C ((1.03 +/- 0.25) mmol/L) and apoA-I ((604.59 +/- 105.79) mmol/L) were significantly lower than those in the non-CHD group (P < 0.05). The concentrations of apoA-I decreased with the increase in vascular damage, but the difference did not reach statistical significance. However, the concentrations of hsCRP and SAA increased with the increase in vascular damage. The unadjusted odd ratios (ORs) (CI) for apoA-I and SAA of the presence of CHD were 0.093 (0.990 - 0.997) (P = 0.00) and 2.571 (1.029 - 6.424) (P < 0.05), respectively. The association between elevated SAA and the presence of CHD was lost after adjusting for lipid status parameter concentrations. The associations between apoA-I, SAA and the extent of CHD remained strong, regardless of confounding variables.
Increased concentrations of SAA represent the inflammatory marker of the extent of coronary stenosis in patients with CHD. In contrast to SAA, the level of apoA-I was also associated with the presence of CHD, indicating that apoA-I was not only a marker of CHD presence but also a quantitative indicator of CHD extent. In short, determining the change apolipoprotein content within HDL particle is a more accurate and effective method to evaluate the impact of HDL on CHD.
高密度脂蛋白胆固醇（HDL-C）水平是冠心病（CHD）的一个强有力的、独立的负向预测因子。在这项横断面研究中，我们研究了 HDL-C 与载脂蛋白 A-I（apoA-I）和血清淀粉样蛋白 A（SAA）等 HDL 相关因子之间的相互关系，并在一群中国 CHD 患者中研究了它们与 CHD 的存在和严重程度之间的关系。
224 例连续患者参与了这项研究。从医院记录中获取人口统计学数据。采用标准实验室方法测定血清化学浓度。
CHD 组的高敏 C 反应蛋白（hsCRP）（中位数：1.85mg/L）和 SAA（中位数：9.40mg/L）浓度显著升高（P<0.05），而 HDL-C（（1.03±0.25）mmol/L）和 apoA-I（（604.59±105.79）mmol/L）浓度显著低于非 CHD 组（P<0.05）。apoA-I 浓度随血管损伤程度的增加而降低，但差异无统计学意义。然而，hsCRP 和 SAA 浓度随血管损伤程度的增加而增加。未校正的 apoA-I 和 SAA 对 CHD 存在的比值比（OR）（95%CI）分别为 0.093（0.990-0.997）（P=0.00）和 2.571（1.029-6.424）（P<0.05）。校正脂质状态参数浓度后，SAA 与 CHD 存在之间的关联丢失。apoA-I 和 SAA 与 CHD 严重程度之间的关联仍然很强，无论是否存在混杂变量。
SAA 浓度升高代表 CHD 患者冠状动脉狭窄程度的炎症标志物。与 SAA 相反，apoA-I 水平也与 CHD 的存在相关，表明 apoA-I 不仅是 CHD 存在的标志物，也是 CHD 严重程度的定量指标。简而言之，确定 HDL 颗粒内载脂蛋白含量的变化是一种更准确、更有效的评估 HDL 对 CHD 影响的方法。
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