高密度脂蛋白（HDL）相关的1-磷酸鞘氨醇（S1P）与冠状动脉支架内再狭窄之间的关系。
The relationship between the high-density lipoprotein (HDL)-associated sphingosine-1-phosphate (S1P) and coronary in-stent restenosis.
作者信息
Jing Xiao-Dong, Wei Xiao-Ming, Deng Song-Bai, Du Jian-Lin, Liu Ya-Jie, She Qiang
机构信息
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
出版信息
Clin Chim Acta. 2015 Jun 15;446:248-52. doi: 10.1016/j.cca.2015.04.038. Epub 2015 May 8.
BACKGROUND
High-density lipoprotein (HDL)-associated sphingosine-1-phosphate (S1P) contributed to several beneficial effects in the cardiovascular system. We explored the relationship between the HDL-S1P concentrations and coronary in-stent restenosis (ISR).
METHODS
Fifty consecutive patients with ISR and 50 normal control subjects were included. The serum S1P, HDL-S1P and clinical data were collected to explore the relationships between these parameters and ISR.
RESULTS
The patients with ISR had significantly lower concentrations of serum S1P (96.10 ± 26.33 vs. 113.40 ± 32.72; P = 0.004) and HDL-S1P (32.81 ± 10.02 vs. 42.72 ± 11.75; P < 0.001). All included patients were divided into four quartiles based on their concentrations of HDL-S1P: Quartile 1 (18.63-28.51 ng/ml), Quartile 2 (28.62-37.28 ng/ml), Quartile 3 (37.35-45.27 ng/ml), and Quartile 4 (45.59-79.36 ng/ml). The rates of ISR were 84%, 48%, 40% and 28%, respectively. The patients in Quartile 1 exhibited significantly higher rates of ISR compared with the other groups (P = 0.001). A multivariate stepwise logistic regression analysis indicated that HDL-S1P (OR = 0.846, 95% CI = 0.767-0.932, P = 0.001) was an independent predictor of ISR. An ROC analysis indicated that HDL-S1P = 30.37 ng/ml and had a 90% sensitivity and a 52% specificity in predicting ISR.
CONCLUSIONS
HDL-S1P is an independent predictor of ISR, and patients with higher concentrations of HDL-S1P have a low risk of ISR.
背景
高密度脂蛋白（HDL）相关的1-磷酸鞘氨醇（S1P）对心血管系统有多种有益作用。我们探讨了HDL-S1P浓度与冠状动脉支架内再狭窄（ISR）之间的关系。
方法
纳入50例连续的ISR患者和50例正常对照者。收集血清S1P、HDL-S1P及临床资料，以探讨这些参数与ISR之间的关系。
结果
ISR患者的血清S1P浓度（96.10±26.33对113.40±32.72；P = 0.004）和HDL-S1P浓度（32.81±10.02对42.72±11.75；P < 0.001）显著降低。根据HDL-S1P浓度将所有纳入患者分为四个四分位数：四分位数1（18.63 - 28.51 ng/ml）、四分位数2（28.62 - 37.28 ng/ml）、四分位数3（37.35 - 45.27 ng/ml）和四分位数4（45.59 - 79.36 ng/ml）。ISR发生率分别为84%、48%、40%和28%。四分位数1的患者与其他组相比，ISR发生率显著更高（P = 0.001）。多因素逐步逻辑回归分析表明，HDL-S1P（OR = 0.846，95%CI = 0.767 - 0.932，P = 0.001）是ISR的独立预测因子。ROC分析表明，HDL-S1P = 30.37 ng/ml，在预测ISR时敏感性为90%，特异性为52%。
结论
HDL-S1P是ISR的独立预测因子，HDL-S1P浓度较高的患者ISR风险较低。
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