Ragino Yu I, Kashtanova E V, Murashov I S, Volkov A M, Kurguzov A V, Sadovski E V, Maslatsov N A, Scherbakova L V, Chernjavskii A M, Polonskaya Ya V
Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk.
The Federal State Budgetary Institution National Medical Research Center named after academician E.N. Meshalkin of the Ministry of Health of the Russian Federation, Novosibirsk.
Kardiologiia. 2020 Mar 5;60(2):83-88. doi: 10.18087/cardio.2020.2.n775.
The aim of the study was to study biochemical factors of calcification in stable and unstable plaques of coronary arteries and in the blood of patients with severe coronary atherosclerosis, to find associations of biochemical factors of calcification with the development of unstable atherosclerotic plaque.
The study included 25 men aged 60,4±6,8 years who received coronary bypass surgery. In the course of the operation intraoperative indications in men were from coronary endarteriectomy (s) artery (a - d) and histological and biochemical analyses of the samples of the intima / media. Out of 85 fragments of intima / media of coronary arteries, 15 fragments of unchanged intima / media, 39 fragments of stable atheromatous plaque and 31 fragments of unstable plaque were determined. In homogenates of samples of intima / media (after measurement of protein by the method of Lowry) and in blood by ELISA were determined by biochemical factors of calcification: osteoprotegerin, osteocalcin, an osteopontin, osteonectin, as well as inflammatory factors (cytokines, chemokines).
A significant direct correlation (Spearman coefficient =0.607, p<0.01) between the stages of atherosclerotic focus development to unstable plaque and the degree of calcification of atherosclerotic focus development samples was found. There was an increased content of osteocalcin in stable and unstable plaques by 3.3 times in comparison with the unchanged tissue of intima / media of coronary arteries, as well as in samples with small and dust-like, with coarse-grained calcifications in comparison with samples without calcifications by 2.8 and 2.1 times, respectively. According to multivariate logistic regression analysis, the relative risk of unstable atherosclerotic plaque in the coronary artery is associated with a reduced content of osteocalcin (OR=0.988, 95 % CI 0.978-0.999, p=0.028). Also, the relative risk of calcifications in the atherosclerotic plaque in the coronary artery is associated with an increased content of osteocalcin (OR=1,008, 95 % CI 1,001-1,015, p=0,035). In men with severe coronary atherosclerosis, a significant inverse correlation was found (Spearman coefficient -0.386, p=0.022) between the content of osteoprotegerin in the vascular wall and in the blood.
本研究旨在探讨冠状动脉稳定和不稳定斑块以及重度冠状动脉粥样硬化患者血液中的钙化生化因素，以寻找钙化生化因素与不稳定动脉粥样硬化斑块形成之间的关联。
本研究纳入了25名年龄在60.4±6.8岁接受冠状动脉搭桥手术的男性患者。手术过程中，对男性患者进行冠状动脉内膜切除术时获取术中指征，并对内膜/中膜样本进行组织学和生化分析。在85个冠状动脉内膜/中膜片段中，确定了15个未改变的内膜/中膜片段、39个稳定动脉粥样硬化斑块片段和31个不稳定斑块片段。通过ELISA法在内膜/中膜样本匀浆（采用Lowry法测定蛋白质含量后）和血液中测定钙化生化因素：骨保护素、骨钙素、骨桥蛋白、骨连接蛋白以及炎症因子（细胞因子、趋化因子）。
发现动脉粥样硬化病灶发展至不稳定斑块的阶段与动脉粥样硬化病灶发展样本的钙化程度之间存在显著正相关（Spearman系数=0.607，p<0.01）。与冠状动脉内膜/中膜未改变的组织相比，稳定和不稳定斑块中的骨钙素含量增加了3.3倍，与无钙化样本相比，有小颗粒状和尘状、粗颗粒状钙化的样本中骨钙素含量分别增加了2.8倍和2.1倍。根据多因素逻辑回归分析，冠状动脉中不稳定动脉粥样硬化斑块的相对风险与骨钙素含量降低有关（OR=0.988，95%CI 0.978-0.999，p=0.028）。此外，冠状动脉粥样硬化斑块中钙化的相对风险与骨钙素含量增加有关（OR=1.008，95%CI 1.001-1.015，p=0.035）。在重度冠状动脉粥样硬化男性患者中，血管壁和血液中骨保护素含量之间存在显著负相关（Spearman系数-0.386，p=0.022）。
