Correlation between serum PTH/HDL-C and LDL-C/HDL-C and severity of coronary artery disease
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摘要: 目的:探讨甲状旁腺激素(PTH)/HDL-C、LDL-C/HDL-C在冠状动脉(冠脉)病变严重程度中的预测价值。方法:380例患者接受了冠脉造影,其中对照组为87例冠脉正常患者,其余293例冠心病患者根据Gensini评分分为轻度狭窄组(1~30分)130例与重度狭窄组(≥30分)163例。检测各组患者行冠脉造影前外周血PTH、TC、TG、HDL-C、LDL-C等生化指标,计算PTH/HDL-C及LDL-C/HDL-C并进行统计分析。结果:(1)在冠脉重度狭窄组中PTH、PTH/HDL-C、LDL-C/HDL-C水平显著高于轻度狭窄组及对照组,差异有统计学意义(P＜0.05)。(2)相关性分析显示,PTH、PTH/HDL-C、LDL-C/HDL-C与冠脉病变严重程度呈正相关。(3)多因素Logistic回归分析显示,糖尿病史、吸烟史、PTH/HDL-C、LDL-C/HDL-C、LP(a)是冠脉重度狭窄的独立危险因素。(4)受试者工作特征曲线显示,PTH/HDL-C对重度冠脉狭窄的预测能力明显优于PTH、LDL-C/HDL-C两个指标。结论:PTH/HDL-C及LDL-C/HDL-C是冠脉重度狭窄的独立危险因素,且PTH/HDL-C及LDL-C/HDL-C与冠脉病变的严重程度呈正相关,PTH/HDL-C相比LDL-C/HDL-C对重度冠脉狭窄有更好的预测价值。Abstract: Objective: To investigate the predictive value of PTH/HDL and LDL/HDL in the severity of coronary artery disease. Method: In the study, 380 patients underwent coronary angiography. The control group included 87 patients with normal coronary artery. The remaining CAD patients were divided into two groups according to Gensini score, as 130 patients in the mild disease group(1-30 points) and 163 patients in the severe disease group(≥30 points). PTH, TC, TG, HDL-C, LDL-C and other biochemical indexes were detected before coronary angiography. Result:(1) The levels of PTH, PTH/HDL-C and LDL-C/HDL-C in the severe coronary artery disease group were significantly higher than those in the mild coronary artery disease group and the control group, and the differences were statistically significant(P＜0.05).(2) PTH, PTH/HDL-C, LDL-C/HDL-C were positively correlated with the severity of coronary artery disease.(3) Multivariate Logistic regression analysis showed that diabetes history, smoking history, PTH/HDL-C, LDL-C/HDL-C, LP(a) were independent risk factors for severe coronary stenosis.(4) The receiver operating characteristic curve(ROC curve) showed that the prediction ability of PTH/HDL-C for severe coronary stenosis was significantly better than that of PTH and LDL-C/HDL-C.Conclusion: PTH/HDL-C and LDL-C/HDL-C are independent risk factors for severe coronary artery stenosis, and PTH/HDL-C and LDL-C/HDL-C are positively correlated with the severity of coronary artery disease. Compared with LDL-C/HDL-C, PTH/HDL-C has better predictive value for severe coronary artery stenosis, which has certain guiding significance in clinical practice.
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[1] Mathers CD,Loncar D.Projections of global mortality and burden of disease from 2002 to 2030[J].PLoS Med,2006,3(11):e442.
[2] Cai G.The atherogenic index of plasma is a strong and independent predictor for coronary artery disease in the Chinese Han population[J].Medicine(Baltimore),2017,96(37):e8058.
[3] Weiwei C.Outline of the report on cardiovascular diseases in China[J].Eur Heart J,2016,18(Suppl F):F2-F11.
[4] Cai G,Zhang B,Shi G,et al.The associations between proprotein convertase subtilisin/kexin type 9 E670G polymorphism and the risk of coronary artery disease and serum lipid levels:a meta-analysis[J].Lipids Health Dis,2015,14:149.
[5] Goliasch G,Wiesbauer F,Blessberger H,et al.Premature myocardial infarction is strongly associated with increased levels of remnant cholesterol[J].J Clin Lipidol,2015,9(6):801-806.e1.
[6] Sniderman AD.A meta-analysis of low-density lipoprotein cholesterol,non-high-density lipoprotein cholesterol,and apolipoprotein B as markers of cardiovascular risk[J].Circ Cardiovasc Qual Outcomes,2011,4(3):337-345.
[7] Task Force M.European guidelines on cardiovascular disease prevention in clinical practice:the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice(constituted by representatives of 10 societies and by invited experts):developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation(EACPR)[J].Eur J Prev Cardiol,2016,23(11):NP1-NP96.
[8] Nayor M,Vasan RS.Recent update to the US cholesterol treatment guidelines:a comparison with international guidelines[J].Circulation,2016,133(18):1795-1806.
[9] van Ballegooijen AJ,Reinders I,Visser M,et al.Parathyroid hormone and cardiovascular disease events:A systematic review and meta-analysis of prospective studies[J].Am Heart J,2013,165(5):655-64,664.e1-5.
[10] Larsson SC,Burgess S,Michaelsson K.Association of genetic variants related to serum calcium levels with coronary artery disease and myocardial infarction[J].JAMA,2017,318(4):371-380.
[11] Uysal HB,Daǧlı B,Akgüllü C,et al.Blood count parameters can predict the severity of coronary artery disease[J].Korean J Intern Med,2016,31(6):1093-1100.
[12] 徐慧,刘芳.单核细胞计数/高密度脂蛋白胆固醇比值与早发冠心病的相关性分析[J].临床心血管病杂志,2020,36(8):709-713.
[13] Ryan TJ,Bauman WB,Kennedy JW,et al.Guidelines for percutaneous transluminal coronary angioplasty.A report of the American Heart Association/American College of Cardiology Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures(Committee on Percutaneous Transluminal Coronary Angioplasty)[J].Circulation,1993,88(6):2987-3007.
[14] Gensini GG.A more meaningful scoring system for determining the severity of coronary heart disease[J].Am J Cardiol,1983,51(3):606-607.
[15] Sullivan DR,Marwick TH,Freedman SB.A new method of scoring coronary angiograms to reflect extent of coronary atherosclerosis and improve correlation with major risk factors[J].Am Heart J,1990,119(6):1262-1267.
[16] Horio E,Kadomatsu T,Miyata K,et al.Role of endothelial cell-derived angptl2 in vascular inflammation leading to endothelial dysfunction and atherosclerosis progression[J].Arterioscler Thromb Vasc Biol,2014,34(4):790-800.
[17] Seijkens T,Hoeksema MA,Beckers L,et al.Hypercholesterolemia-induced priming of hematopoietic stem and progenitor cells aggravates atherosclerosis[J].FASEB J,2014,28(5):2202-2213.
[18] Lippi U.Clinical chemical indexes and severity of coronary atherosclerosis[J].Clin Chim Acta,1983,130(3):283-289.
[19] 高坡,韩永生,袁帅帅,等.急性ST段抬高型心肌梗死患者LDL-C/HDL-C比值与冠状动脉病变严重程度的相关性[J].临床心血管病杂志,2019,35(10):903-906.
[20] Perkovic V,Hewitson TD,Kelynack KJ,et al.Parathyroid hormone has a prosclerotic effect on vascular smooth muscle cells[J].Kidney Blood Press Res,2003,26(1):27-33.
[21] Walker MD,Fleischer J,Rundek T,et al.Carotid vascular abnormalities in primary hyperparathyroidism[J].J Clin Endocrinol Metab,2009,94(10):3849-3856.
[22] Hagström E,Michaëlsson K,Melhus H,et al.Plasma-parathyroid hormone is associated with subclinical and clinical atherosclerotic disease in 2 community-based cohorts[J].Arterioscler Thromb Vasc Biol,2014,34(7):1567-1573.
[23] Sedky NK,Hassanein SI,Gad MZ.Independent assortment of GC gene polymorphism(rs 2282679) and 25-hydroxyvitamin D levels in coronary artery disease[J].Can J Physiol Pharmacol,2018,96(4):345-351.
[24] Folsom AR,Alonso A,Misialek JR,et al.Parathyroid hormone concentration and risk of cardiovascular diseases:the Atherosclerosis Risk in Communities(ARIC)study[J].Am Heart J,2014,168(3):296-302.
[25] Ruiz M.High-density lipoprotein-associated apolipoprotein M limits endothelial inflammation by delivering sphingosine-1-phosphate to the sphingosine-1-phosphate receptor 1[J].Arterioscler Thromb Vasc Biol,2017,37(1):118-129.
[26] Keul P.Potent anti-inflammatory properties of HDL in vascular smooth muscle cells mediated by HDL-S1P and their impairment in coronary artery disease due to lower HDL-S1P:a new aspect of HDL dysfunction and its therapy[J].FASEB J,2019,33(1):1482-1495.
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