Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Clin Hypertens (Greenwich). 2023 Dec;25(12):1172-1184. doi: 10.1111/jch.14751. Epub 2023 Nov 20.
This study examined the associations between emerging lipid biomarkers (small dense low-density lipoprotein cholesterol [sdLDL-C), lipoprotein(a) [Lp(a)], and free fatty acids [FFA]), two ratios (sdLDL-C/LDL-C and the triglyceride-glucose [TyG) index), and the Gensini score (GS) in patients with premature coronary artery disease (PCAD) in relation to the extent of coronary stenosis. The authors evaluated a cohort of 2952 individuals undergoing coronary angiography (CAG), encompassing those with PCAD (n = 1749), late-onset coronary artery disease (LCAD; n = 328), and non-coronary artery disease (non-CAD; n = 575). Noteworthy differences were observed in the levels of the novel lipid biomarkers and ratio indexes among the PCAD, LCAD, and non-CAD groups (p < .05). Multiple logistic regression analyses pinpointed Lp(a) (OR = 2.62, 95% CI 1.22-5.63, p = .014) and the TyG index (OR = 2.53, 95% CI 1.08-5.93, p = .033) as independent risk factors for PCAD. Furthermore, these biomarkers and ratio indexes discerned substantial distinctions among PCAD patients with varying GS (p < .05). Consequently, these markers can proficiently anticipate the gravity of coronary artery stenosis (GS > 40) in PCAD patients, as evidenced by the ROC analysis. In conclusion, sdLDL-C, Lp(a), FFA, and the sdLDL-C/LDL-C and TyG indexes have considerable potential as risk and diagnostic markers for coronary artery stenosis in individuals afflicted with PCAD.
这项研究旨在探讨在与冠状动脉狭窄程度相关的情况下，新兴脂质生物标志物（小而密低密度脂蛋白胆固醇 [sdLDL-C]、脂蛋白（a）[Lp(a)]和游离脂肪酸 [FFA]）、两个比值（sdLDL-C/LDL-C 和甘油三酯-葡萄糖 [TyG]指数）以及 Gensini 评分（GS）与早发冠心病（PCAD）患者之间的关联。作者评估了 2952 名接受冠状动脉造影（CAG）的个体，包括 PCAD（n=1749）、晚发冠状动脉疾病（LCAD；n=328）和非冠状动脉疾病（non-CAD；n=575）患者。在 PCAD、LCAD 和 non-CAD 组之间，新型脂质生物标志物和比值指数的水平存在显著差异（p<.05）。多因素逻辑回归分析指出，Lp(a)（OR=2.62，95%CI 1.22-5.63，p=0.014）和 TyG 指数（OR=2.53，95%CI 1.08-5.93，p=0.033）是 PCAD 的独立危险因素。此外，这些生物标志物和比值指数在不同 GS 的 PCAD 患者之间存在显著差异（p<.05）。因此，这些标志物可以通过 ROC 分析有效地预测 PCAD 患者冠状动脉狭窄的严重程度（GS>40）。总之，sdLDL-C、Lp(a)、FFA 以及 sdLDL-C/LDL-C 和 TyG 指数在 PCAD 患者的冠状动脉狭窄风险和诊断标志物方面具有很大的潜力。
