The oxidation ratio of LDL: a predictor for coronary artery disease.
The oxidation ratio of LDL: a predictor for coronary artery disease.
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DOI：
10.1155/2008/371314
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Dong Y
中科院分区：
文献类型：
--
作者：
Huang H;Mai W;Liu D;Hao Y;Tao J;Dong Y
目的：氧化型低密度脂蛋白胆固醇（ox-LDL-C）被认为是引发和加速动脉粥样硬化（AS）的关键因素。本研究旨在探讨氧化型低密度脂蛋白（ox-LDL）和氧化型低密度脂蛋白（LDL）氧化比值（ox-LDL）诊断冠心病的敏感性和特异性。首次研究了ox-LDL与ALB的比值（ox-LDL/ALB）。 方法与结果：测定急性心肌梗死患者血氧化低密度脂蛋白（ox-LDL）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、白蛋白（ALB）对照组（n = 60）、不稳定型心绞痛（UAP）组（n = 80）、稳定型心绞痛（SAP）组（n = 80）。通过竞争性ELISA测定Ox-LDL。各病组ox-LDL水平及氧化LDL比值（ox-LDL/TC、ox-LDL/HDL-C、ox-LDL/ LDL-C、ox-LDL/ALB）均显著高于对照组（P < 0.001）。冠心病组合并高血压和/或糖尿病者ox-LDL及LDL氧化率进一步升高（P < 0.001）。AMI组Ox-LDL/ALB为正常对照组的7倍（0.068 ± 0.017vs0.009 ± 0.007，P < 0.001）。受试者工作特征曲线（ROC曲线）的曲线下面积（AUC）是评价疾病诊断准确性的指标。ox-LDL/TC、ox-LDL/HDL-C、ox-LDL、ox-LDL/ALB、ox-LDL/ LDL-C诊断冠心病的ROC曲线下面积分别为0.975、0.975、0.966、0.966、0.957（P < 0.001）。当ox-LDL/TC = 0.175时，诊断冠心病的敏感性和特异性分别为0.917和0.925，两者基本相等，提示冠心病的漏诊率和误诊率最低。 结论：ox-LDL水平、ox-LDL/TC、ox-LDL/LDL-C、ox-LDL/HDL-C、ox-LDL/ALB比值是较TC、TG、HDL-C、LDL-C更好的鉴别冠心病患者与健康人的生物标志物。ox-LDL /TC比值高的患者可能有更高的冠心病风险。
Objective: Oxidized LDL cholesterol (ox-LDL-C) is considered to be a key factor of initiating and accelerating atherosclerosis (AS). The purpose of this study is to elucidate the sensitivity and specificity of ox-LDL and oxidation ratio of LDL in the diagnosis of coronary artery disease (CAD). For the first time, we investigated the ratio of ox-LDL to ALB(ox-LDL/ALB). Methods and results: Blood ox-LDL, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and albumin (ALB) were measured in patients with acute myocardial infarction (AMI, n = 80), unstable angina pectoris (UAP, n = 80), stable angina pectoris (SAP, n = 80), normal control (n = 60), and dyslipidemia control (n = 60). Ox-LDL was measured by competitive ELISA. The level of ox-LDL and oxidation ratio of LDL(ox-LDL/TC, ox-LDL/HDL-C, ox-LDL/ LDL-C and ox-LDL/ALB) were significantly higher in each diseased group than controls (P < 0.001). In CAD group, ox-LDL and oxidation ratio of LDL in subjects complicated with hypertension (HT) and/or diabetes mellitus (DM) increased further (P < 0.001). Ox-LDL/ALB in the AMI group was 7 times higher than normal control group (0.068 ± 0.017 vs 0.009 ± 0.007, P < 0.001). The area under the curve (AUC) of receiver operating characteristic curve (ROC curve) is a criterium to evaluate the accuracy of diagnosing a disease. The AUC of ROC curve of ox-LDL/TC, ox-LDL/HDL-C, ox-LDL, ox-LDL/ALB and ox-LDL/ LDL-C for diagnosing CAD were 0.975, 0.975, 0.966, 0.966, 0.957 respectively (P < 0.001). When ox-LDL/TC = 0.175, the sensitivity and specificity of diagnosing CAD were 0.917 and 0.925, which were almost equal to each other, indicating that the rates of missed diagnosis and misdiagnosis for CAD were the lowest. Conclusions: The level of ox-LDL and the ratio of ox-LDL/TC, ox-LDL/LDL-C, ox-LDL/HDL-C and ox-LDL/ALB are better biomarkers than TC, TG, HDL-C and LDL-C for discriminating between patients with coronary artery disease and healthy subjects. And patients who have a high ratio of ox-LDL /TC may have a higher risk for CAD.
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