Shanghai Municipality Key Laboratory of Veterinary Biotechnology, School of Agriculture and Biology, Shanghai Jiao Tong University.
Department of Physical examinations, The Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University.
J Atheroscler Thromb. 2019 Sep 1;26(9):762-774. doi: 10.5551/jat.46821. Epub 2019 Jan 17.
Endothelial lipase (EL), hepatic lipase (HL), and lipoprotein lipase (LPL) are all triglyceride lipases and are associated with coronary artery disease (CAD). However, whether they can be simultaneous independent risk factors for CAD is unknown. In the present study, we investigated whether the three lipases can be independent risk factors simultaneously for CAD and whether combining these lipases could provide greater predictive power than high-density lipoprotein cholesterol (HDL-c) for the development of CAD.
Eighty-six patients with CAD and 65 healthy controls were enrolled in the study. Additionally, 38 patients who underwent one-year follow-up angiography after percutaneous coronary intervention with stent implantation were collected to investigate in-stent restenosis. Serum EL, HL, and LPL concentrations were measured and compared with other coronary risk factors.
Serum EL and HL concentrations were both significantly increased in patients with CAD or in-stent restenosis, whereas serum LPL concentration was reduced significantly in patients with CAD. Multivariate logistic regression analysis indicated that the three lipases were simultaneous independent risk factors for CAD. However, only serum EL concentration was considered an independent risk factor for in-stent restenosis. Importantly, the receiver operating characteristic curve showed that the combined measurement of the three lipases displayed better predictive power than HDL-c or any one of the three lipases for CAD.
Serum EL concentration was an independent risk factor for both CAD and in-stent restenosis. Moreover, the combined assessment of serum EL, HL, and LPL concentrations as multiple risk factors provided potent predictive power for CAD.
内皮脂肪酶(EL)、肝脂肪酶(HL)和脂蛋白脂肪酶(LPL)均为甘油三酯脂肪酶,与冠状动脉疾病(CAD)有关。然而,它们是否可以同时作为 CAD 的独立危险因素尚不清楚。本研究旨在探讨这三种脂肪酶是否可以同时作为 CAD 的独立危险因素,以及联合这些脂肪酶是否比高密度脂蛋白胆固醇(HDL-c)对 CAD 的发展具有更大的预测能力。
本研究纳入 86 例 CAD 患者和 65 例健康对照者。此外,还收集了 38 例经皮冠状动脉介入支架植入术后进行了为期一年的血管造影随访的患者,以探讨支架内再狭窄情况。测量并比较了血清 EL、HL 和 LPL 浓度与其他冠状动脉危险因素。
CAD 或支架内再狭窄患者的血清 EL 和 HL 浓度均显著升高,而 CAD 患者的血清 LPL 浓度显著降低。多变量 logistic 回归分析表明,这三种脂肪酶均为 CAD 的同时独立危险因素。然而,只有血清 EL 浓度被认为是支架内再狭窄的独立危险因素。重要的是,受试者工作特征曲线显示,三种脂肪酶的联合测量比 HDL-c 或三种脂肪酶中的任何一种对 CAD 都具有更好的预测能力。
血清 EL 浓度是 CAD 和支架内再狭窄的独立危险因素。此外,联合评估血清 EL、HL 和 LPL 浓度作为多种危险因素,对 CAD 具有强大的预测能力。