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根据心血管疾病患者的高血糖水平升高的氧化型低密度脂蛋白水平:结构方程模型研究。

Increase in oxidized low-density lipoprotein level according to hyperglycemia in patients with cardiovascular disease: A study by structure equation modeling.

机构信息

Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.

Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.

出版信息

Diabetes Res Clin Pract. 2020 Mar;161:108036. doi: 10.1016/j.diabres.2020.108036. Epub 2020 Jan 29.

Abstract

AIMS

Malondialdehyde-modified low-density lipoprotein (MDA-LDL) level has been reported to be strongly associated with the pathogenesis of cardiovascular diseases. We focused on diabetic status and investigated its possible contribution to MDA-LDL level.

METHODS

The study sample consisted of 2705 patients who were admitted to our hospital and underwent cardiac catheterization. Blood samples were obtained to measure the levels of fasting blood sugar (FBS), hemoglobin A1c (HbA1c), insulin, LDL, MDA-LDL and others. Body mass index (BMI) was also used in constructing structural equation modeling and Bayesian estimation.

RESULTS

To explore the factors theoretically associated with MDA-LDL level, we performed structural equation modeling. We generated a path model that revealed that BMI, LDL level and FBS were significantly associated with MDA-LDL level (P < 0.001 for each factor), whereas insulin level and HbA1c level were not significantly associated (P = NS for both factors). Noted above was clearly demonstrated on the image of 2-D contour line by Bayesian structure equation modeling.

CONCLUSIONS

This study clearly showed that hyperglycemia affects MDA-LDL level. An interaction between diabetes and dyslipidemia was shown in terms of activation of lipid oxidation.

摘要

目的

丙二醛修饰的低密度脂蛋白(MDA-LDL)水平与心血管疾病的发病机制密切相关。我们关注糖尿病状态,并研究其对 MDA-LDL 水平的可能贡献。

方法

研究样本包括 2705 名因心脏导管插入术而入院的患者。采集血样以测量空腹血糖(FBS)、糖化血红蛋白(HbA1c)、胰岛素、LDL、MDA-LDL 等水平。体重指数(BMI)也用于构建结构方程模型和贝叶斯估计。

结果

为了探讨与 MDA-LDL 水平理论上相关的因素,我们进行了结构方程建模。我们生成了一个路径模型,表明 BMI、LDL 水平和 FBS 与 MDA-LDL 水平显著相关(每个因素的 P<0.001),而胰岛素水平和 HbA1c 水平与 MDA-LDL 水平无显著相关性(两个因素的 P=NS)。贝叶斯结构方程模型的二维等高线图像清楚地显示了上述结果。

结论

本研究清楚地表明,高血糖会影响 MDA-LDL 水平。糖尿病和血脂异常之间的相互作用表现为脂质氧化的激活。

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