Glycation of apoprotein A-I is associated with coronary artery plaque progression in type 2 diabetic patients.
Glycation of apoprotein A-I is associated with coronary artery plaque progression in type 2 diabetic patients.
复制标题
载脂蛋白 A-I 的糖化与 2 型糖尿病患者的冠状动脉斑块进展相关
DOI：
10.2337/dc12-1411
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发表时间：
2013-05
期刊：
影响因子：
16.2
通讯作者：
Shen WF
中科院分区：
文献类型：
--
作者：
Pu LJ;Lu L;Zhang RY;Du R;Shen Y;Zhang Q;Yang ZK;Chen QJ;Shen WF
目的探讨载脂蛋白(Apo)A-I糖基化水平与2型糖尿病患者冠状动脉病变(CAD)及斑块进展的关系。研究设计与方法连续375例接受定量冠状动脉造影和血管内超声检查的2型糖尿病患者中，82例无明显狭窄(管腔狭窄30%[I组])和190例有明显冠状动脉病变(管腔狭窄70%[II组])，分析≥A-I糖化水平和血清卵磷脂：胆固醇酰基转移酶(LCAT)活性。对照组为136例健康受试者。在1年的随访中，主要对II组患者进行血管造影和血管内超声检查，以评估斑块进展情况。结果在对照组、I组和II组中，载脂蛋白A-I糖基化的相对强度逐渐升高，血清LCAT活性逐渐降低。这两项指标与II组的冠状动脉病变支数和病变范围指数相关。在1年的随访中，QCA检测到159例患者的45例斑块进展，IVUS发现127例患者的38例斑块进展。有斑块进展的患者与无斑块进展的患者相比，载脂蛋白A-I糖基化的基线相对强度显著增加，其值与QCA和IVUS测量的变化有关。多变量回归分析显示，载脂蛋白A-I糖基化的基线相对强度是2型糖尿病患者冠心病和斑块进展的独立决定因素。结论ApoA-I糖化水平与2型糖尿病患者冠状动脉病变严重程度和冠状动脉斑块进展有关。
OBJECTIVE To investigate whether glycation level of apoprotein (apo)A-I is associated with coronary artery disease (CAD) and plaque progression in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Among 375 consecutive type 2 diabetic patients undergoing quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS), 82 patients with nonsignificant stenosis (luminal diameter narrowing <30% [group I]) and 190 patients with significant CAD (luminal diameter stenosis ≥70% [group II]) were included for analysis of apoA-I glycation level and serum activity of lecithin: cholesterol acyltransferase (LCAT). The control group had 136 healthy subjects. At the 1-year follow-up, angiography and IVUS were repeated mainly in group II patients for plaque progression assessment. RESULTS Relative intensity of apoA-I glycation by densitometry was increased, and serum LCAT activity was decreased stepwise across groups control, I, and II. These two measurements were associated with the number of diseased coronary arteries and extent index in group II. During 1-year follow-up, QCA detected 45 patients with plaque progression in 159 subjects, and IVUS found 38 patients with plaque progression in 127 subjects. Baseline relative intensity of apoA-I glycation was significantly increased in patients with plaque progression compared with those without, with values associated with changes in QCA and IVUS measurements. Multivariable regression analysis revealed that baseline relative intensity of apoA-I glycation was an independent determinant of CAD and plaque progression in type 2 diabetic patients. CONCLUSIONS ApoA-I glycation level is associated with the severity of CAD and coronary artery plaque progression in type 2 diabetic patients.