Burgmaier Mathias, Reith Sebastian, Schurgers Leon, Kahles Florian, Marx Nikolaus, Reutelingsperger Chris
1 Department of Cardiology, Medical Clinic I, University Hospital of the RWTH Aachen, Aachen, Germany.
2 Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.
Diab Vasc Dis Res. 2017 Sep;14(5):415-422. doi: 10.1177/1479164117710392. Epub 2017 Jun 7.
Annexin A5 (anxA5) is involved in processes which are crucial in atherogenesis. However, anxA5's relationship with atherosclerotic lesion extension and plaque composition in high-risk patients with type 2 diabetes remains unclear. Thus, we characterized the association between circulating anxA5 levels with atherosclerotic burden and coronary plaque composition in diabetes mellitus patients.
Intima-media thickness was determined in 96 diabetes mellitus patients with stable coronary artery disease. Furthermore, intracoronary optical coherence tomography was performed in 106 lesions to determine plaque composition.
AnxA5 plasma levels of patients with intima-media thickening were higher (3.49 ± 2.19 ng/mL) compared to patients with normal intima-media thickness (2.24 ± 1.67 ng/mL, p = 0.002). Furthermore, anxA5 was associated with intima-media thickening on univariable [odds ratio = 1.445 (1.106-1.889), p = 0.007] and multivariable [odds ratio = 1.643 (1.166-2.314), p = 0.005] logistic regression analysis when adjusted for multiple cardiovascular risk factors and biomarkers. Furthermore, receiver operating characteristic analysis demonstrated that anxA5 predicted intima-media thickening with low-moderate diagnostic efficiency [area under the curve = 0.700 (0.592-0.808)]. In contrast, there was no association between anxA5 levels and coronary plaque composition as assessed by optical coherence tomography including the presence of lipid, calcified, fibrous plaque or the minimal thickness of the fibrous cap overlying the necrotic lipid core ( p = ns).
Circulating anxA5 levels are associated with carotid intima-media thickness but not coronary plaque composition in high-risk patients with diabetes mellitus.
膜联蛋白A5（anxA5）参与动脉粥样硬化形成过程中的关键步骤。然而，在2型糖尿病高危患者中，anxA5与动脉粥样硬化病变扩展及斑块成分之间的关系仍不明确。因此，我们对糖尿病患者循环anxA5水平与动脉粥样硬化负荷及冠状动脉斑块成分之间的关联进行了特征分析。
对96例患有稳定型冠状动脉疾病的糖尿病患者测定其内膜中层厚度。此外，对106个病变进行冠状动脉内光学相干断层扫描以确定斑块成分。
内膜中层增厚患者的anxA5血浆水平（3.49±2.19 ng/mL）高于内膜中层厚度正常的患者（2.24±1.67 ng/mL，p = 0.002）。此外，在单变量[比值比 = 1.445（1.106 - 1.889），p = 0.007]和多变量[比值比 = 1.643（1.166 - 2.314），p = 0.005]逻辑回归分析中，在校正多种心血管危险因素和生物标志物后，anxA5与内膜中层增厚相关。此外，受试者工作特征分析表明，anxA5预测内膜中层增厚的诊断效率为低至中等[曲线下面积 = 0.700（0.592 - 0.808）]。相比之下，通过光学相干断层扫描评估的anxA5水平与冠状动脉斑块成分之间无关联，包括脂质、钙化、纤维斑块的存在或坏死脂质核心上方纤维帽的最小厚度（p = 无显著差异）。
在糖尿病高危患者中，循环anxA5水平与颈动脉内膜中层厚度相关，但与冠状动脉斑块成分无关。
