脂蛋白亚组分部分介导了血尿酸与冠心病的关系。

PubMed ID
发表日期 2015年Feb月

原始出处 国际临床化学杂志
Clinica chimica acta; international journal of clinical chemistry
作者 Zhang  Yan  Xu  Rui-Xia  Li  Sha  Zhu  Cheng-Gang  Guo  Yuan-Lin  Sun  Jing  Li  Jian-Jun 

文献标题 脂蛋白亚组分部分介导了血尿酸与冠心病的关系。
Lipoprotein subfractions partly mediate the association between serum uric acid and coronary artery disease.

文献摘要 BACKGROUND

血清尿酸(SUA)与冠心病(CAD)易感性和脂质代谢密切相关,但其机制尚不清楚。近年来,脂蛋白亚组分在冠心病风险评估中的应用越来越受到重视。因此,我们试图探讨SUA与CAD之间的关系是否部分由脂蛋白亚组分介导。

METHODS

共有401名连续接受冠状动脉造影的受试者入选。收集基线临床资料,包括血清尿酸水平和血脂谱。脂蛋白亚组分用脂印系统测定。

RESULTS

在总体人群中,上SUA五分位组的致动脉粥样硬化脂质参数和不平衡脂蛋白亚组分显著升高,特别是小密度低密度脂蛋白胆固醇(sdLDL-C)和大密度高密度脂蛋白胆固醇(HDL-C)显著降低(p<0.05)。男女间SUA和脂蛋白亚组分水平差异显著。经性别等传统危险因素校正后,多元线性回归分析显示SUA与sdLDL-C呈正相关(β=0.113,p=0.013),与HDL-C水平呈负相关(β=0.152,p=0.002)。鉴于SUA水平与脂蛋白亚组分和冠心病发病率有显著相关性(校正OR=1.312,95%CI 1.069-1.609,p=0.009),我们进行了中介分析,发现8.7-10.5%的SUA对冠心病易感性的影响是由sdLDL-C升高或大HDL-C降低介导的(p<0.05)。

CONCLUSIONS

SUA水平与脂蛋白亚组分sdLDL-C(阳性)和HDL-C(阴性)有关,部分介导了SUA与冠心病易感性的关系。


BACKGROUND

Serum uric acid (SUA) has been established to be highly associated with coronary artery disease (CAD) susceptibility and lipid metabolism, but the underlying mechanisms are unclear. Recently, lipoprotein subfractions have been proposed to be more valuable in CAD risk evaluation. Hence, we sought to investigate whether the relationship between SUA and CAD is partly mediated by lipoprotein subfractions.

METHODS

A total of 401 consecutive subjects undergoing coronary angiography were enrolled. The baseline clinical data including the SUA level and lipid profiles were collected. The lipoprotein subfractions were determined using the Lipoprint system.

RESULTS

In the overall population, the upper SUA quintiles had significantly higher atherogenic lipid parameters and unbalanced lipoprotein subfractions especially higher small dense low-density lipoprotein-cholesterol (sdLDL-C) and lower large high-density lipoprotein-cholesterol (HDL-C) (p<0.05). The levels of SUA and lipoprotein subfractions were dramatically different between male and female. After adjusting for traditional risk factors including gender, multivariate linear regression analysis suggested that SUA was positively associated with sdLDL-C (β=0.113, p=0.013) but negatively related to large HDL-C level (β=-0.152, p=0.002). Given the significant association of the SUA level with lipoprotein subfractions and incident CAD (adjusted OR=1.312, 95% CI 1.069-1.609, p=0.009), we performed the mediation analyses and found that 8.7-10.5% of the effect of SUA on CAD susceptibility was mediated by the increased sdLDL-C or decreased large HDL-C level (p<0.05).

CONCLUSIONS

The SUA level was proved to be associated with lipoprotein subfractions including sdLDL-C (positive) and large HDL-C (negative), which partly mediated the association between SUA and CAD susceptibility.


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