Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Diabetes Metab Res Rev. 2019 May;35(4):e3128. doi: 10.1002/dmrr.3128. Epub 2019 Feb 7.
Clusterin plays an important role in the cardiovascular system, and serum levels of clusterin are higher in coronary artery disease patients. Here, we measured serum clusterin levels in premature coronary artery disease (PCAD) patients and explored the association of these levels with PCAD risk.
Serum samples and general clinical information were obtained from 672 subjects including 364 PCAD subjects, 126 non-PCAD subjects, and 182 controls.
Serum clusterin levels were higher in PCAD patients than in controls, particularly in males with body mass index (BMI) < 25 kg/m (P < 0.0001). Compared with the lowest tertile of clusterin, the odds ratio of PCAD in the highest tertile was higher in both a univariate and three adjustment models, and it was 3.146-fold higher in Model 3. This association was especially significant in subgroups with BMI < 25 kg/m , total cholesterol < 5.7 mmol/L, high-density lipoprotein cholesterol ≥ 1.0 mmol/L, Urea < 7.14 mmol/L, and estimated glomerular filtration rate < 90 mL/min/1.73 m . Serum clusterin may be a potential diagnostic biomarker for PCAD (sensitivity 60.7%, specificity 51.6%, area under the curve 0.595 [95% CI, 0.544-0.647], P < 0.0001), and a combination of clusterin with clinical variables in Model 3 resulted in improved diagnostic accuracy (sensitivity 86.3%, specificity 64.2%, area under the curve 0.829 [95% CI, 0.782-0.877], P < 0.0001).
Serum clusterin levels were increased in PCAD patients, especially for males with BMI < 25 kg/m . Higher clusterin levels were independently associated with the presence of PCAD, particularly in subjects with normal BMI, lower total cholesterol, urea, estimated glomerular filtration rate, and higher high-density lipoprotein cholesterol. Clusterin might be a potential diagnostic biomarker for PCAD patients, especially in combination with clinical variables.
簇集蛋白在心血管系统中发挥重要作用，冠心病患者血清簇集蛋白水平较高。在这里，我们测量了早发冠心病（PCAD）患者的血清簇集蛋白水平，并探讨了这些水平与 PCAD 风险的关系。
从 672 名受试者中获得血清样本和一般临床信息，其中包括 364 名 PCAD 患者、126 名非 PCAD 患者和 182 名对照。
PCAD 患者的血清簇集蛋白水平高于对照组，尤其是 BMI<25kg/m2 的男性（P<0.0001）。与簇集蛋白最低三分位相比，最高三分位的 PCAD 比值在单因素和三种调整模型中均较高，在模型 3 中为 3.146 倍。这种相关性在 BMI<25kg/m2、总胆固醇<5.7mmol/L、高密度脂蛋白胆固醇≥1.0mmol/L、尿素<7.14mmol/L 和估计肾小球滤过率<90mL/min/1.73m 的亚组中尤其显著。血清簇集蛋白可能是 PCAD 的潜在诊断生物标志物（灵敏度 60.7%，特异性 51.6%，曲线下面积 0.595[95%CI，0.544-0.647]，P<0.0001），并且簇集蛋白与模型 3 中的临床变量相结合可提高诊断准确性（灵敏度 86.3%，特异性 64.2%，曲线下面积 0.829[95%CI，0.782-0.877]，P<0.0001）。
PCAD 患者的血清簇集蛋白水平升高，尤其是 BMI<25kg/m2 的男性。较高的簇集蛋白水平与 PCAD 的存在独立相关，尤其是在 BMI 正常、总胆固醇、尿素、估计肾小球滤过率较低和高密度脂蛋白胆固醇较高的患者中。簇集蛋白可能是 PCAD 患者的潜在诊断生物标志物，特别是与临床变量结合使用时。
