Department of Biochemistry, Jinling Hospital, Clinical School of Medicine, Nanjing University, Nanjing, China.
J Atheroscler Thromb. 2012;19(1):81-9. doi: 10.5551/jat.9340. Epub 2011 Nov 7.
To investigate the possible mechanisms and association of increased complexes of β(2)-glycoprotein I with lipoprotein(a) [β(2)-GPI-Lp(a)] levels with the presence and extent of coronary artery disease (CAD).
β(2)-GPI-Lp(a) levels were measured in 116 patients with acute coronary syndromes (ACS), 72 patients with stable CAD and 100 control subjects.
Compared to the control, β(2)-GPI-Lp(a) levels (expressed after logarithmically transformation: ACS, 0.22±0.45 U/mL; stable CAD, 0.05±0.55 U/mL; control, -0.31±0.61 U/mL) significantly increased in both patients with ACS (p <0.001) and stable CAD (p <0.001). Univariate logistic regression analysis of risk factors revealed that the presence of β(2)-GPI-Lp(a), ox-Lp(a) or Lp(a) was a strong risk factor for stable CAD [β(2)GPI-Lp(a), OR 3.17, 95% CI 1.65, 6.07; ox-Lp(a), OR 2.54, 95% CI 1.33, 4.85; Lp(a), OR 3.00, 95% CI 1.56, 5.75; respectively], and especially for ACS [β(2)-GPI-Lp(a), OR 5.38, 95% CI 2.97, 9.74; ox-Lp(a), OR 7.55, 95% CI 4.12, 13.84; Lp(a), OR 4.33, 95% CI 2.40, 7.80; respectively]. In multivariate analysis, adjusting for age, sex and plasma lipid levels, the presence of β(2)-GPI-Lp(a) or Lp(a) was a risk factor for both stable CAD and ACS. Ox-Lp(a) was a risk factor only for ACS, while not for stable CAD. β(2)-GPI-Lp(a) levels were found to be positively associated with Lp(a), ox-Lp(a), maximal stenosis and a number of vessel diseases in patients with ACS or stable CAD, respectively. Multiple linear regression analysis found that ox-Lp(a) and maximal stenosis accounted for 46.2% of the variation in β(2)-GPI-Lp(a) levels.
Elevated levels of β(2)-GPI-Lp(a) are associated with the presence and severity of CAD, and may be a strong risk factor for atherosclerosis.
探讨β（2）-糖蛋白 I 与脂蛋白（a）[β（2）-GPI-Lp（a）]复合物水平升高与冠心病（CAD）的发生和严重程度的可能机制和相关性。
测定 116 例急性冠脉综合征（ACS）患者、72 例稳定型 CAD 患者和 100 例对照者的β（2）-GPI-Lp（a）水平。
与对照组相比，ACS 患者（ACS：0.22±0.45 U/mL；稳定 CAD 患者：0.05±0.55 U/mL；对照组：-0.31±0.61 U/mL）和稳定 CAD 患者（p<0.001）的β（2）-GPI-Lp（a）水平（经对数转换后表示）均显著升高。单因素 logistic 回归分析显示，β（2）-GPI-Lp（a）、氧化型 Lp（a）或 Lp（a）的存在是稳定型 CAD 的一个强危险因素[β（2）-GPI-Lp（a），OR 3.17，95%CI 1.65，6.07；氧化型 Lp（a），OR 2.54，95%CI 1.33，4.85；Lp（a），OR 3.00，95%CI 1.56，5.75；分别]，尤其是 ACS [β（2）-GPI-Lp（a），OR 5.38，95%CI 2.97，9.74；氧化型 Lp（a），OR 7.55，95%CI 4.12，13.84；Lp（a），OR 4.33，95%CI 2.40，7.80；分别]。在多因素分析中，校正年龄、性别和血浆脂质水平后，β（2）-GPI-Lp（a）或 Lp（a）的存在是稳定型 CAD 和 ACS 的危险因素。氧化型 Lp（a）是 ACS 的危险因素，而不是稳定型 CAD 的危险因素。β（2）-GPI-Lp（a）水平与 ACS 或稳定型 CAD 患者的 Lp（a）、氧化型 Lp（a）、最大狭窄程度和血管疾病数量呈正相关。多元线性回归分析发现，氧化型 Lp（a）和最大狭窄程度占β（2）-GPI-Lp（a）水平变化的 46.2%。
β（2）-GPI-Lp（a）水平升高与 CAD 的发生和严重程度相关，可能是动脉粥样硬化的一个强危险因素。
