Department of Cardiology, Necmettin Erbakan University Meram Medicine Faculty, Konya, Turkey,
Department of Cardiology, Haseki Training and Research Hospital, Istanbul, Turkey.
Med Princ Pract. 2019;28(6):573-580. doi: 10.1159/000503085. Epub 2019 Sep 4.
Heparanase (HPA), mammalian endo-β-D-glu-cu-ronidase, separates heparan sulfate chains of proteoglycans and changes the structure of the extracellular matrix. We investigated whether serum levels of HPA differ in patients with stable coronary artery disease (SCAD) and subjects with normal coronary arteries.
This study enrolled 92 patients with SCAD and 34 controls with normal coronary arteries. Levels of HPA were measured by a commercially available human HPA enzyme-linked immunosorbent assay kit.
Serum HPA levels were significantly lower in the SCAD group (137.5 [104.1-178.9] vs. 198.8 [178.2-244.9] pg/mL; p < 0.001). Serum HPA levels were significantly higher in subjects with diabetes mellitus (DM) compared to those without DM (p = 0.008). Levels of HPA were lower in the SCAD group, both in the diabetic and nondiabetic subgroups, as compared to controls (p < 0.001 for both subgroups). Levels of HPA positively correlated with fasting blood glucose (FBG) (r: 0.42; p < 0.001). In multiple logistic regression analysis, serum HPA level (odds ratio [OR]: 0.975; 95% confidence interval [CI]: 0.966, 0.985; p < 0.001) and FBG (OR: 1.028; 95% CI: 1.010, 1.047; p = 0.002) were independently associated with SCAD. The receiver operating characteristic curve showed that HPA levels less than 160.6 pg/mL predicted SCAD with 65% sensitivity and 97% specificity (AUC: 0.80; 95% CI: 0.728, 0.878; p < 0.001).
Diabetes and FBG levels were closely associated with serum levels of HPA. Low serum levels of HPA may predict SCAD in both diabetic and nondiabetic populations.
肝素酶（HPA）是一种哺乳动物内切-β-D-葡糖醛酸糖苷酶，能够将蛋白聚糖的肝素硫酸盐链分离，并改变细胞外基质的结构。我们研究了稳定性冠状动脉疾病（SCAD）患者和正常冠状动脉患者的血清 HPA 水平是否存在差异。
本研究纳入了 92 例 SCAD 患者和 34 例正常冠状动脉对照者。采用商业上可获得的人 HPA 酶联免疫吸附测定试剂盒测定 HPA 水平。
SCAD 组患者血清 HPA 水平显著低于对照组（137.5[104.1-178.9]比 198.8[178.2-244.9]pg/ml；p<0.001）。与无糖尿病者相比，糖尿病患者血清 HPA 水平显著升高（p=0.008）。与对照组相比，糖尿病和非糖尿病亚组的 SCAD 患者的 HPA 水平均较低（两组均 p<0.001）。HPA 水平与空腹血糖（FBG）呈正相关（r：0.42；p<0.001）。在多变量 logistic 回归分析中，血清 HPA 水平（比值比[OR]：0.975；95%置信区间[CI]：0.966，0.985；p<0.001）和 FBG（OR：1.028；95%CI：1.010，1.047；p=0.002）与 SCAD 独立相关。受试者工作特征曲线显示，HPA 水平低于 160.6pg/ml 时，预测 SCAD 的敏感性为 65%，特异性为 97%（曲线下面积[AUC]：0.80；95%CI：0.728，0.878；p<0.001）。
糖尿病和 FBG 水平与血清 HPA 水平密切相关。低水平的 HPA 可能预测糖尿病和非糖尿病人群中的 SCAD。
