Department of Traditional Chinese Medicine, Peking University International Hospital, China.
Department of Clinical Laboratory, Peking University People's Hospital, China.
Dis Markers. 2021 May 10;2021:5597028. doi: 10.1155/2021/5597028. eCollection 2021.
Coronary heart disease (CHD) is a common and severe complication in type 2 diabetes mellitus (T2DM) patients. Increased amount of circulatory small dense low-density lipoprotein cholesterol (sdLDL-C) particles is known to be a sign of dyslipidemia and can result in atherosclerosis. However, the association between serum sdLDL-C levels and CHD in T2DM patients remains unclear.
A total of 3684 T2DM patients who received selective coronary angiography (CAG) were selected. For analyzing the association between sdLDL-C and CHD severity in T2DM, the patients with CHD were further divided into four subgroups according to the quartiles of sdLDL-C. A multivariate logistic regression was used for analyzing the risks and severity of CHD. A total of 3427 patients with continuous stable CHD were recruited and followed up for 5 years.
Serum sdLDL-C levels in the CHD group were significantly increased compared with those in the non-CHD group [0.80 (0.49) mmol/L vs. 0.70 (0.30) mmol/L, < 0.001]. The results from CHD subgroup analysis indicated that the sdLDL-C levels in patients with multiple-vessel disease and high Gensini score (GS) were significantly increased. By adjusting the confounding factors and analyzing with multiple logistic regression, we found that sdLDL-C independently correlated with the presence and severity of CHD (CHD: OR = 2.257; multiple-vessel disease: OR = 3.288; high GS: OR = 2.554). A total of 484 major cardiovascular events (MACEs) were documented. After Kaplan-Meier analysis and chi-squared analysis, the incidence of MACEs in the high sdLDL-C group was higher than that in the low sdLDL-C group (16.04% vs. 12.25%, = 0.002).
In T2DM patients, elevated serum sdLDL-C may increase the severity of CHD and predict cardiovascular events in the future. Therefore, serum sdLDL-C may be a potential biomarker for the surveillance of CHD in T2DM patients.
冠心病（CHD）是 2 型糖尿病（T2DM）患者常见且严重的并发症。循环中小而密的低密度脂蛋白胆固醇（sdLDL-C）颗粒数量的增加被认为是血脂异常的标志，并可导致动脉粥样硬化。然而，血清 sdLDL-C 水平与 T2DM 患者 CHD 之间的关系尚不清楚。
选择了 3684 例接受选择性冠状动脉造影（CAG）的 T2DM 患者。为了分析 T2DM 患者血清 sdLDL-C 水平与 CHD 严重程度之间的关系，根据 sdLDL-C 的四分位数，将 CHD 患者进一步分为四组。采用多元逻辑回归分析 CHD 的风险和严重程度。共招募了 3427 例连续稳定的 CHD 患者，并进行了 5 年的随访。
CHD 组血清 sdLDL-C 水平明显高于非 CHD 组[0.80（0.49）mmol/L vs. 0.70（0.30）mmol/L， < 0.001]。CHD 亚组分析结果表明，多支血管病变和高 Gensini 评分（GS）患者的 sdLDL-C 水平显著升高。通过调整混杂因素并进行多元逻辑回归分析，我们发现 sdLDL-C 与 CHD 的发生和严重程度独立相关（CHD：OR = 2.257；多支血管病变：OR = 3.288；高 GS：OR = 2.554）。共记录到 484 例主要心血管不良事件（MACEs）。经 Kaplan-Meier 分析和卡方检验，sdLDL-C 水平高组的 MACE 发生率高于 sdLDL-C 水平低组（16.04%比 12.25%， = 0.002）。
在 T2DM 患者中，血清 sdLDL-C 水平升高可能增加 CHD 的严重程度，并预测未来心血管事件的发生。因此，血清 sdLDL-C 可能是监测 T2DM 患者 CHD 的潜在生物标志物。
