血清HDL-S1P水平与冠状动脉狭窄的相关性分析

Association between serum level of high-density lipoprotein-associated sphingosine 1-phosphate and coronary artery stenosis

摘要:

目的：探讨血清中与高密度脂蛋白（high-density lipoproteins，HDL）结合的1-磷酸鞘氨醇（sphingosine-1-phosphate，S1P）即HDL-S1P与冠状动脉狭窄的相关性。方法：纳入冠状动脉造影检查确诊冠脉狭窄的患者共40例（狭窄组），并选取同期冠脉造影明确无狭窄者40例（对照组）做对照，收集患者的一般临床资料，通过超速离心法分离出血清中HDL，使用高效液相色谱测定HDL-S1P浓度，并通过ELISA试剂盒测定血清超敏C反应蛋白水平，采用多因素分析方法讨论其与冠状动脉狭窄的相关性。结果：①冠状动脉狭窄组血清总S1P、HDL-S1P及HDL水平低于对照组，超敏C反应蛋白水平高于对照组[HDL-S1P：（34.17±10.62） ng/mL vs. （44.66±11.94） ng/mL，P=0.000；HDL：（1.01±0.24） mmol/L vs. （1.18±0.39） mmol/L，P=0.024；超敏C反应蛋白：（2.96±1.40） mg/L vs. （2.10±0.99） mg/L，P=0.002]；②逐步logistic回归分析显示，HDL-S1P是冠脉狭窄的独立保护因素（OR=0.904，95%CI=0.856~0.956，P=0.000），超敏C反应蛋白是独立危险因素（OR=1.734，95%CI=1.121~2.682，P=0.013）。结论：HDL-S1P可能是冠脉狭窄的独立预测因素，冠脉狭窄发生可能与血清HDL-S1P水平下降有关。

Abstract:

Objective：To explore the association between serum level of high-density lipoprotein-associated sphingosine 1-phosphate （HDL-S1P） and coronary artery stenosis. Methods：A total of 40 patients confirmed by coronary angiography with coronary artery stenosis were selected as stenosis group，while 40 others confirmed without stenosis were selected as control group. General clinical data of the two groups were collected. HDL was isolated from serum by ultracentrifugation，and HDL-S1P concentration was de－termined by high-performance liquid chromatography. C-reactive protein concentration was determined by enzyme-linked immunosor－bent assay. Multivariate analysis was performed to assess the association of HDL-S1P and C-reactive protein with coronary artery stenosis. Results：Compared with the control group，the stenosis group had significantly lower serum levels of total S1P，HDL-S1P，and HDL and a significantly higher C-reactive protein concentration[HDL-S1P：（34.17±10.62） ng/mL vs. （44.66±11.94） ng/mL，P=0.000；HDL：（1.01±0.24） mmol/L vs. （1.18±0.39） mmol/L，P=0.024；C-reactive protein：（2.96±1.40） mg/L vs. （2.10±0.99） mg/L，P=0.002]. Stepwise logistic regression analysis showed that HDL-S1P was an independent protective factor for coronary artery stenosis（OR=0.904，95%CI=0.856 to 0.956，P=0.000），while C-reactive protein was an independent risk factor（OR=1.734，95%CI=1.121 to 2.682，P=0.013）. Conclusion：HDL-S1P might be an independent predictor of coronary artery stenosis，the development of which may be associated with a decrease in serum HDL-S1P.