摘要
目的探讨老年稳定性冠心病合并糖尿病患者神经酰胺(Cer)与低密度脂蛋白胆固醇(LDL-C)的相关性。方法纳入2018年3~8月解放军总医院国家老年疾病临床医学研究中心门诊体检的老年稳定性冠心病合并糖尿病患者276例,其中资料完整的患者共269例,根据LDL-C中位数水平分为低LDL-C组134例(LDL-C<2.29 mmol/L)和高LDL-C组135例(LDL-C≥2.29mmol/L)。采集患者基线临床资料。通过液相色谱-串联质谱法检测血浆中4种Cer水平:Cer16︰0、Cer18︰0、Cer24︰1和Cer24︰0。比较2组Cer水平,分析Cer与LDL-C的相关性。结果与低LDL-C组比较,高LDL-C组Cer16︰0、Cer18︰0、Cer24︰1和Cer24︰0明显升高,差异有统计学意义(P<0.01)。Person相关性分析显示,Cer16︰0、Cer18︰0、Cer24︰1与年龄、TC、TG、LDL-C、高敏肌钙蛋白T呈正相关(P<0.05,P<0.01)。多元线性回归分析显示,在校正年龄、传统心血管危险因素及全血糖化血红蛋白后Cer16︰0、Cer18︰0、Cer24︰1及Cer24︰0与LDL-C呈正相关(B=2.826,95%CI:1.977~3.675,P=0.001;B=4.202,95%CI:1.667~6.738,P=0.001;B=0.308,95%CI:0.043~0.574,P=0.023;B=0.262,95%CI:0.178~0.346,P=0.001)。结论在老年冠心病合并糖尿病患者中,不同循环Cer与LDL-C呈正相关,可能是冠心病合并糖尿病的危险因素之一,Cer可能是一种新的心脏代谢性疾病的生物标志物。
Objective To investigate the correlation between circulating ceramides and LDL-C in elderly patients with CHD and T2DM.Methods A total of 276 elderly patients with CHD and T2DM who took health examination in our clinical research center from March to August 2018 were enrolled in this study.Among them,269 patients with complete medical data were eligible for analysis.According to the median level of LDL-C,they were divided into low LDL-C group(<2.29 mmol/L,n=134)and high LDL-C group(≥2.29 mmol/L,n=135).The baseline clinical data were collected.Four ceramide levels in the plasma were detected by liquid chromatography tandem mass spectrometry(LC-MS/MS):Cer 16:0,Cer 18:0,Cer 24:1 and Cer 24:0.The ceramide levels were compared between the two groups,and the correlation between ceramides and LDL-C was analyzed.Results Compared with the low LDL-C group,the Cer 16:0,Cer 18:0,Cer 24:1 and Cer 24:0 levels were significantly higher in the high LDL-C group(P<0.01).Person correlation analysis showed that Cer 16:0,Cer 18:0 and Cer 24:1 were positively correlated with age,TC,TG,LDL-C and hs-cTnT(P<0.05,).Multiple linear regression analysis indicated that after adjustment for age,conventional cardiovascular risk factors and hyperglycated hemoglobin,Cer 16:0,Cer 18:0,Cer 24:1 and Cer 24:0 were positively correlated with LDL-C(B=2.826,95%CI:1.977-3.675,P=0.001;B=4.202,95%CI:1.667-6.738,P=0.001;B=0.308,95%CI:0.043-0.574,P=0.023;B=0.262,95%CI:0.178-0.346,P=0.001).Conclusion In elderly patients with CHD and T2DM,different circulating ceramides are positively correlated with LDL-C,which may be one of the risk factors of CHD complicated with T2DM.Ceramides may be a new biomarker of cardiometabolic disease.
作者
曹瑞华
房之沂
张继彬
胡文超
芦婷婷
范利
曹丰
Cao Ruihua;Fang Zhiyi;Zhang Jibin;Hu Wenchao;Lu Tingting;Fan Li;Cao Feng(Department of Cardiology,National Clinical Research Center for Geriatric Diseases,Second Medical Centre Chinese PLA General Hospital Beijing 100853,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第7期676-679,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(82200496)
军队保健专项科研课题(18BJZ32)。
关键词
冠心病
糖尿病
神经酰胺类
胆固醇
LDL
数据相关性
coronary disease
diabetes mellitus
ceramides
cholesterol,LDL
correlation of data
