| Objective: Oxidized low-density lipoprotein(ox-LDL)plays a vital role in the occurrence and development of atherosclerosis(AS),which is closely related to coronary heart disease(CHD).Superoxide dismutase(SOD),as one of the most important antioxidant enzymes,can remove oxygen free radicals in the body and protect cells and tissues from oxidative damage.Overexpression of SOD can reduce the level of reactive oxygen species(ROS)and reduce oxidative stress damage to a certain extent.This study aims to explore the diagnostic value of ox-LDL and its different oxidation rates(ox-LDL/LDL,ox-LDL/HDL)in CHD by detecting ox-LDL and SOD,and to understand the oxidative stress state in CHD patients.Methods: From April to September 2019,225 patients who were admitted to the Department of Cardiology of the First Hospital of Lanzhou University and met the inclusion criteria were divided into acute myocardial infarction group(AMI n=63)and unstable angina group(UAP n=61).Stable angina group(SAP n =41)and control group(n=60).According to whether the first three groups of patients were combined with hypertension(HT)or diabetes(DM),they were divided into 4 subgroups,namely CHD group(n=60),CHD + DM group(n=11),CHD + HT group(n=61),CHD + HT + DM group(n=33).All selected patients underwent coronary angiography.The history data of all the participants were collected and included,including sex,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),past history(smoking history,DM,HT,cerebral infarction),etc.the blood lipids included cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),lowdensity lipoprotein cholesterol(LDL-C),and fasting Blood glucose(FPG),uric acid(UA),homocysteine(Hcy),leukocyte(WBC),and non high density lipoprotein cholesterol(N-HDL-C)were calculated.The ox-LDL,ox-LDL/LDL and ox-LDL/HDL in peripheral blood were detected by enzyme-linked immunosorbent assay(ELISA),and the SOD level in peripheral blood was detected by WST-1.Pearson correlation analysis or difference analysis were used to analyze the relationship between ox-LDL and related lipids and other markers.ROC was used to detect the level of related plasma markers to understand the ability of auxiliary diagnosis of CHD.Logistic regression model was used to analyze the risk factors affecting CHD.Results: 1.There is no statistically significant difference in LDL-C and TC between the AMI group and the control group(p>0.05),and HDL-C is statistically different between the two(p<0.05).2.Plasma OX-LDL level in AMI group is significantly higher than that in UAP group,SAP group and control group(p<0.001,p<0.001,p<0.001),UAP group OXLDL level is significantly higher than control group(p <0.001).The ox-LDL level in the SAP group is not statistically different from that in the control group(p>0.05).The ox-LDL/LDL ratios in the AMI group,UAP group,and SAP group are significantly higher than those in the control group(p<0.001,p<0.001,p<0.001).The ox-LDL/HDL ratio in the AMI group is significantly higher than that in the other three groups(p<0.001),the ox-LDL / HDL ratio in the UAP group is significantly higher than that in the SAP group(p<0.001),and the ox-LDL/HDL ratio in the SAP group is comparable to the control.There are no statistical difference between the groups(p>0.05).Plasma SOD levels are not statistically different among the four groups after pairwise comparison(p>0.05).3.In the subgroup analysis,there is no significant difference between ox-LDL,oxLDL/LDL,ox-LDL/HDL and SOD in CHD group,CHD + DM group,CHD + HT group,CHD + HT + DM group Statistical difference(p>0.05).4.In the correlation analysis,ox-LDL has a significant positive correlation with TG(r=0.186,p=0.005),and has no correlation with TC,HDL-C,LDL-C,N-HDL-C.ox-LDL/LDL is significantly negatively correlated with TC(r =-0.414,p = 0.000),and has no correlation with HDL-C and TG.ox-LDL/HDL is significantly positively correlated with TG(r=0.298,p=0.000);negatively correlated with TC(r =-0.140,p = 0.036),and has no correlation with LDL-C,ox-LDL,ox-LDL/LDL,ox-LDL/HDL are positively correlated with UA(r=0.153,p=0.022;r=0.147,p=0.028),and have no correlation with SOD,smoking,age,blood pressure,etc.5.In ROC curve analysis,the area under the curve(AUC)of ox-LDL is(0.706 95% CI: 0.608~0.804)greater than 0.7(P<0.001).The AUC of ox-LDL/LDL and oxLDL/HDL are respectively(0.655 95% CI: 0.558~0.753;0.668 95% CI: 0.568~0.768)greater than 0.50(P<0.001).The AUC of TC,HDL-C,LDL-C,N-HDL-C are respectively(0.613 95% CI: 0.529~0.697;0.598 95% CI: 0.516~0.680;0.599 95% CI: 0.515~0.684;0.607 95% CI: 0.522~0.692)greater than 0.5(P<0.05).ox-LDL is of great value in the diagnosis and prediction of CHD.6.Multivariate logistic regression analysis found that HDL-C,LDL-C,and oxLDL are independent risk factors that affected the incidence of CHD.The ROC curve prediction model is drawn,and the results showed AUC(0.806 95% CI: 0.731 ~ 0.881),the best cutoff value is 0.710,the corresponding sensitivity is 84.8%,and the specificity is 66.7%.Conclusion: 1.Plasma ox-LDL level is related to the instability of plaques in patients with CHD,and its diagnostic value for CHD is superior to traditional lipid markers(TC,LDL-C,etc.).ox-LDL/LDL,ox-LDL/HDL may reflect the state of oxidative stress in patients with CHD.2.In this study,SOD could not yet play the role of oxidative stress damage caused by ox-LDL in patients with CHD.3.ox-LDL,LDL and HDL are independent risk factors that affect the incidence of CHD.The combined analysis of the three can improve the prediction and diagnosis value of CHD. |
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