ABO血型与血脂和PCSK9相关性研究  

The relation of ABO blood group to plasma lipids and proprotein convertase subtilisin/kexin type 9

作　　者：高莹 李莎 徐瑞霞 郭远林 张彦 朱成刚 吴娜琼 孙静[1] 李建军 

机构地区：[1]国家心血管病重点实验室中国医学科学院阜外医院血脂异常与心血管疾病诊治中心,北京市100037

出　　处：《中国心血管病研究》2016年第6期501-507,共7页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金，首都临床特色应用研究基金，首都医学发展科研基金，北京自然科学基金，高等学校博士学科点专项科研基金

摘　　要：目的 探讨ABO血型和前蛋白转化酶枯草杆菌蛋白酶9（PCSK9）水平之间的联系.方法 人选507例行诊断性或治疗性冠状动脉造影检查的患者,收集基线数据并用ELISA法评价血浆PCSK9水平.结果 非O型受试者与O型受试者相比,总胆固醇（TC）[（5.07± 1.14） mmol/L比（4.78±1.01）mmol/L]、低密度脂蛋白胆固醇（LDL-C）[（3.35± 1.08） mmol/L比（3.12±0.91）mmol/L]、非高密度脂蛋白胆固醇（NHDL-C）[（3.94±1.10）mmol/L比（3.68±1.01）mmol/L]、载脂蛋白B（ApoB）[（1.0±0.28）g/L比（0.96±0.27）g/L]和PCSK9[226.32（118.91～279.28）ng/ml比202.33（171.27～254.31）ng/ml]水平更高（P均＜0.05）.PCSK9水平明显与TC、LDL-C 、NHDL-C和apoB呈正相关（r=0.253,P＜0.01;r=0.262,P＜0.01;r=0.215,P＜0.01;r=0.187,P＜0.01）.多变量回归分析显示,ABO血型与PCSK9水平显著而且独立相关（β=7.91,P=0.009）.中介分析显示,ABO血型对PCSK9的作用8％～19％是通过TC、LDL-C或NHDL-C水平介导的.结论 本研究首次指出ABO血型可能是PSCK9的重要决定因素.PCSK9与ABO血型之间的联系也可能在一定程度上参与了冠心病的发病.Objective Proprotein convertase subtilisin/kexin type 9 （PCSK9）, a newly-identified mem- ber that plays an essential role in cholesterol homeostasis and holds decent promise for hyperlipidemia and coronary artery disease （CAD） treatment. However, the determining factors of PCSK9 are not well-characterized. It is well established that ABO blood group is associated with cholesterol metabolism. Therefore, the relationship between ABO blood groups and plasma PCSK9 level was examined. Methods A group of 507 consecutive patients under- going diagnostic or interventional coronary angiography were enrolled in this cross-sectional study. The baseline clinical characteristics were collected, and the plasma PCSK9 levels were determined using ELISA. Results As a result, subjects of non-O type had higher levels of total cholesterol（TC ） [ （ 5.07± 1.14 ）mmol/L vs （4.78± 1.01 ） mmol/L], low density lipoprotein cholesterol （LDL-C）[ （3.35±1.08）mmol/L vs （3.12±0.91）mmol/L], non high density lipoprotein cholesterol （ NHDL-C ） [ （ 3.94± 1.10 ）mmol/L vs （ 3.68± 1.01 ）mmol/L ], apolipoprotein B （ apo B ） [ （ 1.00±0.28 ）g/L vs （0.96±0.27）g/L], and PCSK91226.32（ 118.91-279.28 ）ng/ml vs 202.33（ 171.27-254.31 ） ng/ml] compared with that of O type （P〈0.05, all）. PCSK9 levels were significantly and positively related to TC, LDL, NHDL-C, and apo B （r=0.253, P〈0.01, r=0.262, P〈0.01, r=0.215, P〈0.01, r=0.187, P〈0.01, respective- ly ）. Multivariable regression analysis revealed that ABO group was significantly and independently associated with PCSK9 level （fl=7.91 ,P=0.009）. Additionally, mediation analysis indicated that ≈8%-19% of the effect of ABO blood group on PCSK9 levels was mediated by TC, LDL-C or NHDL-C levels. Conclusion These data firstly suggested that the ABO blood group might be a significant determinant factor for plasma PCSK9 level. It is also possible that the observed association between PCSK9 and ABO blood group might be in part i

关 键 词：前蛋白转化酶枯草杆菌蛋白酶9 血脂 ABO血型 冠状动脉疾病 PROPROTEIN CONVERTASE subtilisin/kexin type 9 

分 类 号：R541.4[医药卫生—心血管疾病]