High-sensitivity CRP may be a marker of HDL dysfunction and remodeling in patients with acute coronary syndrome.
High-sensitivity CRP may be a marker of HDL dysfunction and remodeling in patients with acute coronary syndrome.
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高敏CRP可能是急性冠脉综合征患者HDL功能障碍和重构的标志物。
DOI：
10.1038/s41598-021-90638-0
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发表时间：
2021-06-01
影响因子：
4.6
通讯作者：
Peng D
中科院分区：
文献类型：
--
作者：
Tang X;Mao L;Chen J;Zhang T;Weng S;Guo X;Kuang J;Yu B;Peng D
在冠状动脉疾病（CAD）患者中，进一步增加高密度脂蛋白（HDL）胆固醇（HDL-C）水平作为他汀类药物的添加剂不能降低心血管风险。有研究表明，HDL功能性胆固醇外排能力（CEC）可能比HDL-C更能预测冠心病的发生。CEC测量耗时，不适用于临床环境。因此，探索一种简便易行的CEC评价指标具有重要意义。36例CAD患者和61例非CAD对照者入组本横断面研究。所有CAD患者均合并急性冠脉综合征（ACS）。使用[3 H]胆固醇负载Raw 264.7细胞模型和载脂蛋白B耗尽的血浆（HDL的替代物）测量CEC。质子核磁共振（NMR）光谱用于评估HDL组分和亚类分布。与对照组（13.0 ± 2.2%，p = 0.022）相比，CAD患者（11.9 ± 2.3%）的CEC显著受损。在对照组中，CEC与酶测HDL-C水平（r = 0.358，p = 0.006）或NMR测定的HDL-C水平（NMR-HDL-C，r = 0.416，p = 0.001）呈正相关。冠心病组CEC与HDL-C（r = 0.216，p = 0.206）和NMR-HDL-C（r = 0.065，p = 0.708）无相关性。相反，我们发现高敏C反应蛋白（hsCRP）水平与CEC呈负相关（r =-0.351，p = 0.036）。多元回归分析显示，在调整其他心血管危险因素和HDL-C后，hsCRP水平与CEC相关，但如果调整多项检测，相关性不显著。核磁共振波谱显示高hsCRP水平的患者HDL颗粒向大颗粒移动，这种现象伴随着CEC降低。在冠心病患者中，HDL-C水平不能反映HDL功能。HDL-C和CEC之间的相关性受损可能是由于炎症诱导的HDL亚类重塑。这些假设产生的数据表明，高敏C反应蛋白水平，急性炎症的标志物，可能与高密度脂蛋白功能障碍在ACS受试者。由于研究设计仅限于相关性，不允许进行因果推断，因此仍需进行更大规模、严格设计的研究。
In patients with coronary artery disease (CAD), further increasing the level of high-density lipoprotein (HDL) cholesterol (HDL-C) as an add-on to statins cannot reduce cardiovascular risk. And it has been reported that HDL functional metric—cholesterol efflux capacity (CEC) may be a better predictor of CAD risk than HDL-C. CEC measurement is time-consuming and not applicable in clinical settings. Thus, it is meaningful to explore an easily acquired index for evaluating CEC. Thirty-six CAD patients and sixty-one non-CAD controls were enrolled in this cross-sectional study. All CAD patients had acute coronary syndrome (ACS). CEC was measured using a [3H] cholesterol loading Raw 264.7 cell model with apolipoprotein B-depleted plasma (a surrogate for HDL). Proton nuclear magnetic resonance (NMR) spectroscopy was used to assess HDL components and subclass distribution. CEC was significantly impaired in CAD patients (11.9 ± 2.3%) compared to controls (13.0 ± 2.2%, p = 0.022). In control group, CEC was positively correlated with enzymatically measured HDL-C levels (r = 0.358, p = 0.006) or with NMR-determined HDL-C levels (NMR-HDL-C, r = 0.416, p = 0.001). However, in CAD group, there was no significant correlation between CEC and HDL-C (r = 0.216, p = 0.206) or NMR-HDL-C (r = 0.065, p = 0.708). Instead, we found that the level of high-sensitivity C-reactive protein (hsCRP) was inversely associated with CEC (r = − 0.351, p = 0.036). Multiple regression analysis showed that the hsCRP level was associated with CEC after adjusting other cardiovascular risk factors and HDL-C, although the association would not reach significance if adjusting for multiple testing. NMR spectroscopy showed that HDL particles shifted to larger ones in patients with high hsCRP levels, and this phenomenon was accompanied by decreased CEC. In patients with CAD, the level of HDL-C cannot reflect HDL function. The impaired correlation between HDL-C and CEC is possibly due to an inflammation-induced HDL subclass remodeling. These hypothesis-generating data suggest that hsCRP levels, a marker of acute inflammation, may associate with HDL dysfunction in ACS subjects. Due to the design limited to be correlative in nature, not permitting causal inference and a larger, strictly designed study is still needed.
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DOI：
10.1161/atvbaha.117.310222
发表时间：
2018-03
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
He Y;Kothari V;Bornfeldt KE
通讯作者：
Bornfeldt KE
影响因子：
10.8
作者：
Gomaraschi, Monica;Ossoli, Alice;Calabresi, Laura
通讯作者：
Calabresi, Laura
影响因子：
5.3
作者：
McGarrah RW;Craig DM;Haynes C;Dowdy ZE;Shah SH;Kraus WE
通讯作者：
Kraus WE
DOI：
10.1056/nejmoa1809798
发表时间：
2019-02-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
Ridker PM;Everett BM;Pradhan A;MacFadyen JG;Solomon DH;Zaharris E;Mam V;Hasan A;Rosenberg Y;Iturriaga E;Gupta M;Tsigoulis M;Verma S;Clearfield M;Libby P;Goldhaber SZ;Seagle R;Ofori C;Saklayen M;Butman S;Singh N;Le May M;Bertrand O;Johnston J;Paynter NP;Glynn RJ;CIRT Investigators
通讯作者：
CIRT Investigators
DOI：
10.1016/s2213-8587(15)00126-6
发表时间：
2015-07
期刊：
The lancet. Diabetes & endocrinology
影响因子：
--
作者：
Saleheen D;Scott R;Javad S;Zhao W;Rodrigues A;Picataggi A;Lukmanova D;Mucksavage ML;Luben R;Billheimer J;Kastelein JJ;Boekholdt SM;Khaw KT;Wareham N;Rader DJ
通讯作者：
Rader DJ