Fractional esterification rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography
Fractional esterification rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography
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DOI：
10.1373/clinchem.2003.022558
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发表时间：
2003-11-01
影响因子：
9.3
通讯作者：
Dobiásová, M
中科院分区：
文献类型：
--
作者：
Frohlich, J;Dobiásová, M
背景：我们研究了各种临床和生化指标对血管造影确定的冠状动脉疾病（aCAD）的预测价值。具体来说，我们评估了血浆甘油三酯（TGs）与高密度脂蛋白胆固醇（HDL- c）之比的价值，以及血浆中含载脂蛋白B （apoB）脂蛋白（FERHDL） （HDL和LDL粒径的功能标记物）的胆固醇分数酯化率。方法：将行冠状动脉造影的患者（男性788例，女性320例）分为aCAD（+）阳性组和aCAD（-）阴性组。评估患者年龄、体重指数、腰围、血压、用药、饮酒、吸烟、运动习惯、血浆总胆固醇（TC）、ldl -胆固醇（LDL-C）、hdl -未酯化胆固醇、HDL-C、TG、FERHDL、apoB、log（TG/HDL-C）、TC/HDL-C。脂质和载脂蛋白通过标准实验室程序测量；FERHDL用放射法测定。结果：与aCAD（-）组相比，aCAD（+）组患者年龄更大，吸烟和糖尿病的发生率更高。aCAD（+）组也有较高的TG、apoB、FERHDL和log（TG/HDL-C）和较低的HDL-C值。aCAD（+）患者的腰围更大，血浆TC和TC/HDL-C更高。aCAD（+）男性的血浆LDL-C较高，而女性没有。在多变量logistic模型中，FERHDL、年龄、吸烟和糖尿病是aCAD（+）存在的重要预测因子。如果多变量logistic模型中只包括实验室测试，FERHDL似乎是aCAD（+）的唯一预测因子。当多变量分析忽略FERHDL时，Log（TG/HDL-C）是一个独立的预测因子。结论：FERHDL是冠状动脉粥样硬化病变存在的最佳实验室预测指标。(C) 2003年美国临床化学学会。
Background: We examined the predictive value of various clinical and biochemical markers for angiographically defined coronary artery disease (aCAD). Specifically, we assessed the value of the ratio of plasma triglyceride (TGs) to HDL-cholesterol (HDL-C) and the fractional esterification rate of cholesterol in plasma depleted of apolipoprotein B (apoB)-containing lipoproteins (FERHDL), a functional marker of HDL and LDL particle size.Methods: Patients (788 men and 320 women) undergoing coronary angiography were classified into groups with positive [aCAD(+)] and negative [aCAD(-)] findings. Patient age, body mass index, waist circumference, blood pressure (BP), medications, drinking, smoking, exercise habits, and plasma total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-unesterified cholesterol, HDL-C, TGs, FERHDL, apoB, log(TG/HDL-C), and TC/HDL-C were assessed. Lipids and apoproteins were measured by standard laboratory procedures; FERHDL was determined by a radioassay.Results: Members of the aCAD(+) group were older and had a higher incidence of smoking and diabetes than those in the aCAD(-) group. The aCAD(+) group also had higher TG, apoB, FERHDL, and log(TG/HDL-C) and lower HDL-C values. aCAD(+) women had greater waist circumference and higher plasma TC and TC/HDL-C. aCAD(+) men, but not women, had higher plasma LDL-C. In the multivariate logistic model, the significant predictors of the presence of aCAD(+) were FERHDL, age, smoking, and diabetes. If only laboratory tests were included in the multivariate logistic model, FERHDL appeared as the sole predictor of aCAD(+). Log(TG/HDL-C) was an independent predictor when FERHDL was omitted from multivariate analysis.Conclusions: FERHDL was the best laboratory predictor of the presence of coronary atherosclerotic lesions. (C) 2003 American Association for Clinical Chemistry.