Demir B, Ozyazgan S, Korkmaz G G, Karakaya O, Aciksari G, Uygun T, Onal B, Uzun H
Department of Cardiology Bakirkoy Dr Sadi Konuk Education and Research Hospital, lstanbul, Turkey.
Department of Medical Pharmacology and Clinical Pharmacology, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Clin Lab. 2013;59(11-12):1319-29. doi: 10.7754/clin.lab.2013.121142.
The objective of this study was to evaluate the serum levels of ischemia modified albumin and oxidative stress parameters in patients with cardiac syndrome X.
A total of 61 patients, composed of 32 consecutive patients (24 female, 8 male, average age: 47.63 +/- 9.49 years) diagnosed with cardiac syndrome X by coronary angiography (initially performed following the identification of ischemia by exercise stress test or myocardial perfusion scintigraphy) and a control group of 29 consecutive patients (15 female, 14 male, average age: 49.59 +/- 11.68 years) with similar features without cardiac syndrome X were included in the study. The levels of the ischemia modified albumin (IMA), ferric reducing antioxidant power (FRAP), prooxidant-antioxidant balance (PAB), and advanced protein oxidation products (AOPP) were determined by colorimetric methods.
Patients have significantly higher PAB, AOPP, and IMA levels in the patient group than in the control group (p < 0.01, p < 0.001, and p < 0.02, respectively). Also, serum triglyceride (p < 0.005) and hs-CRP (p < 0.0001) levels were significantly higher in the patient group (p < 0.01, p < 0.001, and p < 0.02, respectively). We found that there was a significant correlation between hs-CRP, plasma PAB (r: 0.258; p < 0.05), AOPP (r: 0.459; p < 0.001), and triglyceride levels (r: 0.404; p < 0.01). Plasma AOPP levels were also significantly positive correlated with triglyceride levels (r: 0.463; p < 0.001). In addition, during the correlation analysis performed on the patient group, a positive correlation was observed between the levels of IMA with the levels of plasma PAB and plasma AOPP (r: 0,994; p < 0.01 and r: 0.857; p < 0.05, respectively) In a multiple linear regression analysis, AOPP levels were significantly related with hs-CRP and triglyceride (R2: 0.380, p < 0.0001 and p < 0.05). Simple linear regression analysis was performed between plasma PAB (as dependent variable) and hs-CRP levels. Plasma PAB levels were related with hs-CRP (R2: 0.258, p < 0.05). Using the receiver-operator characteristic (ROC) curve, the best cut-off values for predicting cardiac syndrome X of PAD, AOPP, IMA, and hs-CRP levels were 88.1 arbitrary units, 68.5 kloramin T micromol/L, 7.17 U/mL, and 1.09 mg/dL, respectively.
Based on the results of our study, the increase in oxidative stress during cardiac syndrome X appears to be related to elevated levels of IMA. Treatment modalities that decrease oxidative stress might be beneficial for the treatment of cardiac syndrome X.
本研究的目的是评估心脏X综合征患者血清中缺血修饰白蛋白水平及氧化应激参数。
本研究共纳入61例患者，其中32例经冠状动脉造影确诊为心脏X综合征（最初是在运动负荷试验或心肌灌注显像发现缺血后进行冠状动脉造影）的连续患者（24例女性，8例男性，平均年龄：47.63±9.49岁），以及29例具有相似特征但无心脏X综合征的连续患者作为对照组（15例女性，14例男性，平均年龄：49.59±11.68岁）。采用比色法测定缺血修饰白蛋白（IMA）、铁还原抗氧化能力（FRAP）、促氧化剂-抗氧化剂平衡（PAB）和晚期蛋白质氧化产物（AOPP）水平。
患者组的PAB、AOPP和IMA水平显著高于对照组（分别为p<0.01、p<0.001和p<0.02）。此外，患者组的血清甘油三酯（p<0.005）和高敏C反应蛋白（hs-CRP）水平（p<0.0001）也显著更高（分别为p<0.01、p<0.001和p<0.02）。我们发现hs-CRP、血浆PAB（r：0.258；p<0.05）、AOPP（r：0.459；p<0.001）和甘油三酯水平（r：0.404；p<0.01）之间存在显著相关性。血浆AOPP水平也与甘油三酯水平显著正相关（r：0.463；p<0.001）。此外，在对患者组进行的相关性分析中，观察到IMA水平与血浆PAB水平和血浆AOPP水平之间存在正相关（分别为r：0.994；p<0.01和r：0.857；p<0.05）。在多元线性回归分析中，AOPP水平与hs-CRP和甘油三酯显著相关（R2：0.380，p<0.0001和p<0.05）。以血浆PAB（作为因变量）和hs-CRP水平进行简单线性回归分析。血浆PAB水平与hs-CRP相关（R2：0.258，p<0.05）。使用受试者工作特征（ROC）曲线，预测心脏X综合征的PAD、AOPP、IMA和hs-CRP水平的最佳截断值分别为88.1任意单位、68.5氯胺T微摩尔/升、7.17 U/mL和1.09毫克/分升。
基于我们的研究结果，心脏X综合征期间氧化应激的增加似乎与IMA水平升高有关。降低氧化应激的治疗方式可能对心脏X综合征的治疗有益。
