Relationship of High-Density Lipoprotein-Associated Arylesterase Activity to Systolic Heart Failure in Patients with and without Type 2 Diabetes
Relationship of High-Density Lipoprotein-Associated Arylesterase Activity to Systolic Heart Failure in Patients with and without Type 2 Diabetes
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高密度脂蛋白相关芳基酯酶活性与患有和不患有 2 型糖尿病的患者收缩性心力衰竭的关系
DOI：
10.1038/s41598-019-42518-x
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发表时间：
2019-04-12
影响因子：
4.6
通讯作者：
Wang, Xiao Qun
中科院分区：
文献类型：
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作者：
Li, Chang;Chen, Jia Wei;Wang, Xiao Qun
高密度脂蛋白（HDL）对心血管疾病的保护作用部分归因于其强大的抗氧化活性，这在糖尿病条件下很大程度上受到损害。在这项研究中，我们分析了高密度脂蛋白的抗氧化活性，对氧磷酶1（PON 1）在高密度脂蛋白颗粒的芳基酯酶活性，在216例连续HF患者（n = 79）或不（n = 137）2型糖尿病，年龄和性别匹配的112糖尿病和189非糖尿病非HF对照。我们发现芳基酯酶活性在有心衰的患者中比没有心衰的患者显著降低，并且在合并糖尿病时进一步降低。在调整了传统危险因素和载脂蛋白A-I水平后，糖尿病患者芳基酯酶活性与左室射血分数呈正相关（r = 0.325，P = 0.020），而非糖尿病患者则无相关性（r = 0.089，P = 0.415），两个亚组中芳基酯酶活性与NT-proBNP和NYHA心功能分级呈负相关。在回归分析中，当芳基酯酶活性低时，糖尿病患者比非糖尿病患者观察到更高的HF风险。总之，我们的数据表明HF患者合并糖尿病时，受损的血清芳基酯酶活性进一步降低。芳基酯酶活性受损与HF的关系在糖尿病患者中尤其增强。
High-density lipoprotein (HDL) confers protection against cardiovascular disease partly attributable to its robust anti-oxidant activities, which is largely impaired in diabetic conditions. In this study, we analyzed the anti-oxidant activity of HDL, as represented by the arylesterase activity of paraoxonase 1 (PON1) in HDL particles, in 216 consecutive HF patients with (n = 79) or without (n = 137) type 2 diabetes, and age- and gender-matched 112 diabetic and 189 non-diabetic non-HF controls. We found arylesterase activity was significantly decreased in patients with than without HF, and was further decreased when comorbid with diabetes. After adjusting for conventional risk factors and apolipoprotein A-I levels, arylesterase activity remained correlated positively with left ventricular ejection fraction in diabetic (r = 0.325, P = 0.020) but not non-diabetic patients (r = 0.089, P = 0.415), and negatively with NT-proBNP and NYHA functional class in both subgroups. In regression analyses, a higher risk of HF was observed in diabetic than non-diabetic patients when having low arylesterase activities. In conclusion, our data demonstrate that impaired serum arylesterase activity in patients with HF is further reduced when comorbid with diabetes. The relationship of impaired arylesterase activity to HF is especially enhanced in diabetic patients.