Department of Ecology, College of Science, University of Kufa, Iraq.
Department of Chemistry, College of Science, University of Kufa, Iraq.
J Trace Elem Med Biol. 2021 Mar;64:126703. doi: 10.1016/j.jtemb.2020.126703. Epub 2020 Dec 4.
Aberrations in endothelial cells, immune and oxidative pathways are associated with atherosclerosis (ATS) and unstable angina (UA). The role of trace elements, minerals, and the endogenous opioid system (EOS) in UA are less well established.
We measured lipid, insulin resistance (IR), and immune, trace element (copper and zinc), mineral (magnesium, calcium), EOS (β-endorphin and mu-opioid receptor (MOR)) and antioxidant (vitamin D3) biomarkers in patients with ATS (n = 60) and UA (n = 60) and healthy controls (n = 58).
ATS patients showed increased atherogenic and IR indices, IL-6, IL-10, β-endorphin, copper and magnesium, and lower zinc than healthy controls. Logistic regression showed that UA was significantly discriminated from ATS without UA with an accuracy of 85.5 % using calcium, IL-10, β-endorphin, MOR, triglycerides, IR (all positively), and copper and vitamin D3 (inversely). Neural networks showed that UA was discriminated from ATS without UA with an area under the ROC curve of 0.942 using MOR, β-endorphin, calcium, insulin resistance, vitamin D3 and copper as input variables. We found that 50.0 % of the variance in IR was explained by the regression on copper, IL-10, IL-6 (all positively), and zinc (inversely), while 32.9 % of the variance in the atherogenic index of plasma was explained by copper, IL-10 (both positively), and magnesium (inversely).
UA is not only mediated by insulin resistance, atherogenicity, and immune disorders, but also by aberrations in the endogenous opioid system and trace elements as well as lowered antioxidant levels. Copper appears to play a key role in IR and atherogenicity.
内皮细胞、免疫和氧化途径的异常与动脉粥样硬化（ATS）和不稳定型心绞痛（UA）有关。微量元素、矿物质和内源性阿片系统（EOS）在 UA 中的作用尚未得到充分证实。
我们测量了 ATS（n=60）和 UA（n=60）患者以及健康对照组（n=58）的脂质、胰岛素抵抗（IR）和免疫、微量元素（铜和锌）、矿物质（镁、钙）、EOS（β-内啡肽和μ-阿片受体（MOR））和抗氧化剂（维生素 D3）生物标志物。
ATS 患者表现出更高的致动脉粥样硬化和 IR 指数、IL-6、IL-10、β-内啡肽、铜和镁，以及较低的锌。逻辑回归显示，UA 与无 UA 的 ATS 显著区分，准确率为 85.5%，使用钙、IL-10、β-内啡肽、MOR、甘油三酯、IR（均为阳性）和铜和维生素 D3（阴性）。神经网络显示，UA 与无 UA 的 ATS 区分，使用 MOR、β-内啡肽、钙、IR 和铜作为输入变量的 ROC 曲线下面积为 0.942。我们发现，IR 的 50.0%的方差由铜、IL-10、IL-6（均为阳性）和锌（阴性）的回归解释，而血浆致动脉粥样硬化指数的 32.9%的方差由铜、IL-10（均为阳性）和镁（阴性）解释。
UA 不仅由胰岛素抵抗、致动脉粥样硬化和免疫紊乱介导，还由内源性阿片系统和微量元素的异常以及抗氧化水平降低介导。铜似乎在 IR 和致动脉粥样硬化中发挥关键作用。
