Effect of renal function on high-density lipoprotein particles in patients with coronary heart disease.

BACKGROUND: Although renal insufficiency and dyslipidemia are known to be closely associated, the effect of kidney function on the size and clinical value of high-density lipoprotein (HDL) particles remains largely unknown, especially in patients with coronary heart disease. METHODS: A total of 419 coronary heart disease patients and 105 non-coronary heart disease patients were included. HDL particle size, represented by HDL-C/apoA-I, was compared between groups stratified by estimated glomerular filtration rate (eGFR) and Gensini scores using standard Student's t test and one-way ANOVA. Pearson's correlation test was performed to analyze the association between eGFR and HDL-C/apoA-I in patients with coronary heart disease. The relationship between HDL particle size and the occurrence of coronary heart disease was explored using Univariate logistic regression analysis. RESULTS: In patients with coronary heart disease, between-group analysis revealed that HDL-C/apoA-I increased as eGFR declined, and significance appeared as eGFR declined to under 60 ml/min·1.73 m2 (P < 0.001), and Pearson's correlation test also confirmed an inverse correlation between eGFR and HDL-C/apoA-I levels in coronary heart disease patients. When stratified by Gensini scores, in coronary heart disease patients with eGFR ≥ 90 mL/(min·1.73 m2), those with higher Gensini scores had smaller HDL-C/apoA-I. However, with or without kidney insufficiency, smaller HDL-C/apoA-I was associated with a higher occurrence of coronary heart disease (P < 0.05). CONCLUSION: With the presence of renal insufficiency, HDL-C/apoA1 was higher in patients with coronary heart disease. Lower HDL-C/apoA1 was still associated with a higher occurrence of coronary heart disease, but the original association between lower HDL-C/apoA1 and more severe coronary artery stenosis was lost in patients with renal insufficiency.

Correlation of lipoprotein(a) with clinical stability and severity of coronary artery lesions in patients with coronary artery disease / 南方医科大学学报

OBJECTIVE@#To analyze the correlation of lipoprotein(a) [Lp(a)] with the clinical stability and severity of coronary artery stenosis in patients with coronary artery disease (CAD).@*METHODS@#A total of 531 patients undergoing coronary angiography in Nanfang Hospital between January, 2013 and December, 2016 were enrolled in this study. At the cutoff Lp(a) concentration of 300 mg/L, the patients were divided into high Lp(a) group (=191) and low Lp(a) group (=340). In each group, the patients with an established diagnosis of CAD based on coronary angiography findings were further divided into stable angina pectoris (SAP) group and acute coronary syndrome (ACS) group. The correlation between the severity of coronary artery stenosis and Lp(a) was evaluated.@*RESULTS@#The patients in high and low Lp(a) groups showed no significant differences in age, gender, body mass index, smoking status, hypertension, or diabetes (>0.05). Multivariate logistic regression analysis revealed that age, gender, and serum levels of low-density lipoprotein cholesterol (LDL-C) and Lp(a) were independent risk factors for CAD in these patients. A high Lp(a) level was associated with an increased risk of CAD (OR=2.443, 95%CI: 1.205-4.951, =0.013). The patients with a high Lp(a) level were at a significantly higher risk of CAD than those with a low Lp(a) level irrespective of a low or high level of LDL-C (=0.006 and 0.020). In the patients with CAD, the ACS group had a significantly higher Lp(a) level than the SAP group ( < 0.001); the proportion of the patients with high Gensini scores was significantly greater in high Lp(a) group than in low Lp(a) group (17.3% vs 5.6%, =0.026), and a linear relationship was found between Lp(a) level and Gensini score (R=0.130, =0.006).@*CONCLUSIONS@#Serum level of Lp(a) is an independent risk factor for CAD, and an increased Lp(a) is the residual risk for CAD. In patients with CAD, a high Lp(a) level is associated with the clinical instability and severity of coronary artery stenosis.

The value of HDL particles,the concordance of HDL-C and apoA-Ⅰ in assessing the severity of coronary artery disease / 实用医学杂志

Objective The study was to analyze the relationship between HDL particles,the level of HDL-C and the concordance of HDL-C and apoA-Ⅰand the degree of coronary stenosis,then to explore their values in predicting coronary artery disease.Methods 591 patients were collected for coronary angiography,and calculated Gensini score respectively.HDL particles and the level of HDL-C,apoA-Ⅰwere analyzed in coronary artery disease (CAD)group and non-CAD group,stable angina pectoris(SAP)group and acute coronary syndrome(ACS)group and four groups divided by quartile of Gensini score(A,B,C,D).To investigate the relationship between the con-cordance of HDL-C and apoA-Ⅰand the severity of coronary artery disease,HDL-C,apoA-Ⅰwere divided into low and high group according to the 50 percentile,then pair wise combination was done into four groups. Results Compared with non-CAD group,HDL particles,the level of HDL-C,apoA-Ⅰwere significantly reduced in CAD group(P<0.001).Compared with SAP group,similar results were found in ACS group.HDL particles,the level of HDL-C,apoA-Ⅰwere decreased gradually in A,B,C,D group(P<0.001).The concordance of HDL-C and apoA-Ⅰwas related to the risk of CAD(P<0.001).The area under curve(AUC)of HDL particles was higher than that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.Conclusions HDL particles,HDL-C,the concordance of HDL-C and apoA-Ⅰwere related to coronary stenosis.The value of HDL particles in predicting CAD risk was su-perior to that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.

Effect and mechanism study of PSRC1 overexpression on foam cell formation of RAW264.7 / 实用医学杂志

Objective To investigate the effect and potential mechanism of PSRC1 overexpression on foam cell formation of oxidized low-density lipoprotein(ox-LDL)-induced RAW264.7. Method After 48-h treat-ment of 100 μg/ml ox-LDL,changes of the accumulation of cholesterol esters in two groups was detected by oil red O staining.The protein expression of SR-AⅠand LDLR was detected by Western blot assay.Besides,ELISA was used to detect levels of IL-6 and TNF-α.Result The accumulation of cholesterol esters was lower in Ad-PSRC1 group than that in Ad-GFP group(P<0.05). The protein expression of SR-AⅠand LDLR was decreased signifi-cantly(P<0.05),and levels of the secreted IL-6 and TNF-α were also significantly decreased(P<0.05).Con-clusion Our data indicates that PSRC1 overexpression suppresses the formation of foam cells through improving lipid metabolism and down-regulating inflammatory cytokine IL-6 and TNF-α in macrophages.