25-羟维生素 D、脂蛋白相关磷脂酶 A2 与 2 型糖尿病患者无症状性冠状动脉疾病的相关性。

Association of 25-hydroxyvitamin D, lipoprotein-associated phospholipase A2 and asymptomatic coronary artery disease in patients with type 2 diabetes mellitus.

机构信息

Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, 366 Taihu Road, Taizhou 225300, China.

Department of Pan-Vascular Management Center, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, 366 Taihu Road, Taizhou 225300, China.

出版信息

Diabetes Res Clin Pract. 2024 Jun;212:111681. doi: 10.1016/j.diabres.2024.111681. Epub 2024 Apr 25.

DOI:10.1016/j.diabres.2024.111681

PMID:38677367

Abstract

AIM

To evaluate the relationship of 25-hydroxyvitamin D (25(OH)D), lipoprotein-associated phospholipase A2 (Lp-PLA2), and coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) patients with no history or symptoms of cardiovascular disease.

METHODS

The study identified 66 pairs of T2DM patients with and without CAD using propensity score matching. All subjects performed coronary computed tomography angiography (CCTA). Data on 25(OH)D, Lp-PLA2, and metabolic indexes were collected and analyzed.

RESULTS

Compared to the patients without CAD, the patients with CAD had lower 25(OH)D levels and the rate of vitamin D sufficiency, but higher Lp-PLA2 levels. Meanwhile, subjects in the vitamin D sufficiency group had a lower prevalence of CAD and Lp-PLA2 levels. Furthermore, 25(OH)D was inversely correlated with Lp-PLA2, Gensini score, Leiden score, segment involvement score, and segment stenosis score (P < 0.05). After adjusting for age, gender, blood lipids and blood pressure, 25(OH)D was associated with a decreased risk of CAD (aOR 0.933, 95 %CI 0.887-0.983, P = 0.009), while Lp-PLA2 was associated with an increased risk of CAD (aOR 1.014, 95 %CI 1.005-1.022, P = 0.002).

CONCLUSIONS

Decreased 25(OH)D and increased Lp-PLA2 could identify patients with a high risk of CAD and are associated with the severity of coronary artery stenosis in T2DM.

摘要

目的

评估 25-羟维生素 D（25（OH）D）、脂蛋白相关磷脂酶 A2（Lp-PLA2）与无心血管疾病病史或症状的 2 型糖尿病（T2DM）患者冠心病（CAD）的关系。

方法

采用倾向评分匹配法，本研究共纳入 66 对 T2DM 伴或不伴 CAD 患者。所有患者均行冠状动脉计算机断层血管造影（CCTA）检查。收集并分析 25（OH）D、Lp-PLA2 和代谢指标等数据。

结果

与无 CAD 患者相比，CAD 患者 25（OH）D 水平和维生素 D 充足率较低，Lp-PLA2 水平较高。此外，维生素 D 充足组 CAD 和 Lp-PLA2 水平较低。进一步分析发现，25（OH）D 与 Lp-PLA2、Gensini 评分、Leiden 评分、节段受累评分和节段狭窄评分呈负相关（P<0.05）。在校正年龄、性别、血脂和血压后，25（OH）D 与 CAD 风险降低相关（OR 0.933，95%CI 0.887-0.983，P=0.009），而 Lp-PLA2 与 CAD 风险增加相关（OR 1.014，95%CI 1.005-1.022，P=0.002）。