冠心病患者血浆PCSK9水平与低密度脂蛋白亚组分的相关性研究  

Relation of Plasma PCSK9 Levels to Lipoprotein Subfractions in Patients with Stable Coronary Artery Disease

作　　者：马春艳[1] 徐瑞霞[1] 姚雨宏 李莎[1] 张彦[1] 李小林[1] 郭远林[1] 朱成刚[1] 李建军[1] MA Chunzvan XU Rui-xia YAO Yu-hong LI Sha ZHANG Yah LI Xiao-lin GUO Yuan-lin ZHU Cheng-gang LI Jian-jun(Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.)

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

出　　处：《中国分子心脏病学杂志》2017年第4期2167-2170,共4页Molecular Cardiology of China

基　　金：首都卫生发展科研专项项目(2016-1-4035);北京协和医学院协和青年基金(2016-XHQN06,3332016023);阜外科研人才支持计划项目(2012-FWXX02)

摘　　要：目的探讨稳定型冠心病患者血浆前蛋白转化酶枯草溶菌素9(PCSK9)与低密度脂蛋白(LDL)亚组分的相关性。方法连续入选未服用降脂药物治疗的稳定型冠心病患者281例,收集基线临床资料,采用ELISA方法检测血浆PCSK9水平、Lipoprint脂蛋白分类检测仪分析LDL亚组分。结果血浆PCSK9水平与中等颗粒LDL-C和小颗粒LDL-C浓度均呈正相关(分别为:r=0.145,p=0.015;r=0.166,p=0.005)。经多因素回归分析调整传统危险因素后,PCSK9水平与中等颗粒和小颗粒LDL-C浓度仍呈独立正相关(分别为β=0.152,p=0.013;β=0.179,p=0.004),与LDL颗粒大小呈显著负相关(β=-0.130,p=0.035)。进一步分析发现,上述相关性仅存在于男性冠心病患者。结论稳定型冠心病患者血浆PCSK9水平不仅与LDL-C浓度相关,且与LDL各亚组分具有相关性,提示PCSK9与LDL亚组分表型分布可能存在潜在相互作用。Objective To investigate the association of plasma proprotein convertase subtilisin kexin type 9（PCSK9） with low density lipoprotein subfractions in patients with stable coronary artery disease（CAD）. Methods A total of 281 consecutive, stable CAD patients who were not treated with lipid-lowering drugs were enrolled. The baseline clinical characteristics were collected, the plasma PCSK9 levels were determined using ELISA, and the LDL subfractions were analyzed by Lipoprint System. Results In the overall population, plasma PCSK9 levels were positively associated with the concentration of intermediate LDL-C and small LDL-C（r=0.145, p=0.015, r=0.166, p=0.005, respectively）. By multivariable regression analysis after adjustment for traditional risk factors,the plasma PCSK9 levels were significantly and independently associated with the concentration of intermediate LDL-C（β=0.152,p=0.013）,small LDL-C（β=0.179, p=0.004）,LDL score（β=0.121,p=0.043）,and mean LDL particle size（β=-0.130, p=0.035）. Further analysis showed that the correlation existed only in male patients with coronary heart disease.Conclusions PCSK9 levels were independently associated with the changes of the concentration of LDL-C and LDL subfractions, suggesting a potential interaction between PCSK9 and LDL subfractions distributions in CAD.

关 键 词：稳定型冠心病 PCSK9 LDL亚组分 

分 类 号：R541.4[医药卫生—心血管疾病]