University of Pittsburgh, Department of Epidemiology, Graduate School of Public Health, Pittsburgh, PA, USA.
Diab Vasc Dis Res. 2010 Jan;7(1):47-55. doi: 10.1177/1479164109346358. Epub 2009 Oct 28.
Given the paucity of data in type 1 diabetes concerning lipoprotein-associated phospholipase A( 2) (Lp-PLA(2)), we examined its prospective relationship with coronary artery disease (CAD), as well as the effect of modification by C-reactive protein (CRP) and haptoglobin genotype, in individuals with type 1 diabetes who are at an increased risk for CAD due to also having macroalbuminuria (n=96). Although Lp-PLA(2) activity was univariately predictive of CAD (HR=1.54 per SD, p=0.009), this relationship was not significant after covariate adjustment (p=0.59). There was a significant interaction between Lp-PLA(2) and CRP (p=0.02), i.e. those with both markers greater than the median level were more likely to have a CAD event than those persons with low levels of both (HR=2.89, p=0.06). When stratified by haptoglobin genotype, Lp-PLA(2) was predictive of CAD in persons with the 2/1 (HR=2.40, p=0.05), but not 2/2 (HR=0.66, p=0.27), genotype. The association between Lp-PLA(2) activity and CAD differs by CRP and haptoglobin genotype in this group of persons with type 1 diabetes and macroalbuminuria.
鉴于 1 型糖尿病中关于脂蛋白相关磷脂酶 A(2)(Lp-PLA(2)))的数据很少，我们研究了其与冠状动脉疾病(CAD)的前瞻性关系，以及 C-反应蛋白(CRP)和结合珠蛋白基因型修饰的影响，在患有 1 型糖尿病且由于也患有大量白蛋白尿而患 CAD 风险增加的个体中(n=96)。尽管 Lp-PLA(2)活性在单变量上可预测 CAD(HR=1.54/SD，p=0.009)，但在调整协变量后，这种关系并不显著(p=0.59)。Lp-PLA(2)和 CRP 之间存在显著的相互作用(p=0.02)，即具有两个标志物都高于中位数水平的人比那些两个标志物水平都低的人更容易发生 CAD 事件(HR=2.89，p=0.06)。根据结合珠蛋白基因型分层，Lp-PLA(2)在 2/1 基因型的人中可预测 CAD(HR=2.40，p=0.05)，但在 2/2 基因型的人中不能预测 CAD(HR=0.66，p=0.27)。在患有 1 型糖尿病和大量白蛋白尿的这组人群中，Lp-PLA(2)活性与 CAD 的关联因 CRP 和结合珠蛋白基因型而异。
