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血清中小而密的低密度脂蛋白胆固醇和脂蛋白(a)浓度与大动脉炎的冠状动脉狭窄有关。

Serum concentrations of small dense low-density lipoprotein cholesterol and lipoprotein(a) are related to coronary arteriostenosis in Takayasu arteritis.

机构信息

Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.

出版信息

J Clin Lab Anal. 2021 Dec;35(12):e23966. doi: 10.1002/jcla.23966. Epub 2021 Oct 28.

Abstract

BACKGROUND

Serum small dense low-density lipoprotein cholesterol (sdLDL-C) and lipoprotein(a) [Lp(a)] levels are related to coronary disease, but their specific associations with coronary arteriostenosis in Takayasu arteritis (TA) have not been ascertained. This study explored the correlations between serum sdLDL-C and Lp(a) levels and coronary arteriostenosis in TA patients as well as the degree of artery stenosis.

METHODS

This retrospective study included 190 TA patients and 154 healthy subjects. TA patients were divided into three categories based on the degree of coronary stenosis: Group I, stenosis >50%; Group II, stenosis 1%-50%; and Group III, stenosis 0%. Independent risk factors for coronary arteriostenosis in TA were identified by logistic regression, followed by receiver operating characteristic curve analysis to determine the specificity and sensitivity of risk factors and Youden's Index score calculation to determine the cutoff points.

RESULTS

Takayasu arteritis patients had significantly higher serum levels of sdLDL-C and Lp(a) than healthy controls (p < 0.0001). The total cholesterol, triglyceride, LDL-C, sdLDL-C, and Lp(a) levels and the sdLDL-C/LDL-C ratio in Group I were significantly higher than those in Groups II and III (p < 0.05). An elevated serum sdLDL-C level elevated the risk of coronary arteriostenosis by 5-fold (cutoff value, 0.605 mmol/l). An increased serum Lp(a) level increased the risk of coronary arteriostenosis by 3.9-fold (cutoff value, 0.045 g/l). An elevated sdLDL-C/LDL-C ratio increased the risk of coronary arteriostenosis by 2.1-fold (cutoff value, 0.258).

CONCLUSIONS

Serum sdLDL-C and Lp(a) levels and sdLDL-C/LDL-C ratio may be used as diagnostic factors for coronary arteriostenosis in TA patients.

摘要

背景

血清小而密的低密度脂蛋白胆固醇(sdLDL-C)和脂蛋白(a)[Lp(a)]水平与冠心病有关,但它们与 Takayasu 动脉炎(TA)患者冠状动脉狭窄的具体关系尚未确定。本研究探讨了血清 sdLDL-C 和 Lp(a)水平与 TA 患者冠状动脉狭窄以及动脉狭窄程度的相关性。

方法

这是一项回顾性研究,纳入了 190 例 TA 患者和 154 例健康对照者。根据冠状动脉狭窄程度,TA 患者分为三组:I 组,狭窄>50%;II 组,狭窄 1%-50%;III 组,狭窄 0%。采用逻辑回归分析确定 TA 患者发生冠状动脉狭窄的独立危险因素,然后进行受试者工作特征曲线分析,以确定危险因素的特异性和敏感性,并计算 Youden 指数得分以确定截断值。

结果

TA 患者的血清 sdLDL-C 和 Lp(a)水平明显高于健康对照组(p<0.0001)。I 组的总胆固醇、三酰甘油、LDL-C、sdLDL-C 和 Lp(a)水平以及 sdLDL-C/LDL-C 比值明显高于 II 组和 III 组(p<0.05)。血清 sdLDL-C 水平升高使冠状动脉狭窄的风险增加 5 倍(截断值,0.605mmol/l)。血清 Lp(a)水平升高使冠状动脉狭窄的风险增加 3.9 倍(截断值,0.045g/l)。sdLDL-C/LDL-C 比值升高使冠状动脉狭窄的风险增加 2.1 倍(截断值,0.258)。

结论

血清 sdLDL-C、Lp(a)水平和 sdLDL-C/LDL-C 比值可作为 TA 患者冠状动脉狭窄的诊断因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c5/8649385/0be7248955ce/JCLA-35-e23966-g002.jpg

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