Study On Serum Monosaccharide Composition And Its Clinical Significance In Patients With Acute Coronary Syndrome

Objectives:By detecting the composition of free and degradable monosaccharides in serum,the distribution characteristics of serum monosaccharides in acute coronary disease(ACS)and healthy subjects were investigated--namely,the"glycan fingerprint"of the diseases.To investigate the ability of serum monosaccharide to distinguish the severity of arterial stenosis in patients with acute myocardial infarction.To compare the difference of serum free glucose/mannose ratio(G/M)between ACS patients and healthy controls,and to explore the indexes that can be used to evaluate the prognosis of the disease.Methods:Serum from acute coronary syndrome patients(including 258 cases of unstable angina and 163 of acute myocardial infarction)who were hospitalized into the west coast of the affiliated hospital of Qingdao university cardiovascular department from December,2018to December 2019 were collected.At the same time,serum of 204 cases of healthy people were collected from the west coast of the affiliated hospital of Qingdao university physical examination medical center.The clinical data of two groups and angiographic features of ACS patients were collected.Fasting blood in the morning was collected.After centrifugation,serum was taken and stored in a refrigerator at-80~oC.PCR auxiliary acid solution treatment serum and high-performance liquid chromatography(HPLC)analysis were used to compare the difference in monosaccharides between patients with acute myocardial infarction and healthy controls,patients with unstable angina and healthy controls,and the Gensini score<60 and Gensini score≥60.Monosaccharides include free monosaccharides(mannose(Man-F),glucose(Glc-F))and degraded monosaccharides(mannose(Man),glucosamine(Glc N),galactosamine(Gal N),glucose(Glc),galactose(Gal)and fucose(Fuc)).Logistic regression was used to construct diagnostic models(M1-3)of serum monosaccharides for the differential diagnosis between acute myocardial infarction patients and healthy control group,unstable angina patients and healthy control group,acute myocardial infarction patients with Gensini score<60 and Gensini score≥60.Chi-square test,t test,Mann-Whitney U test,logistic regression and receiver operating characteristic curve(ROC)were used.Results:1.The distributions of the six degraded monosaccharides(mannose,glucose,glucosamine,galactosamine,galactose and fucose)were different between healthy people and ACS.ACS has its own unique“glycan fingerprint”.Only glucose and galactose were statistically elevated in AMI patients compared with healthy subjects.Glucose was higher in UA patients than that in healthy subjects while the other five degraded monosaccharides were significantly lower.2.The diagnostic model M1 based on serum monosaccharide had good diagnostic value for AMI.The sensitivity and specificity of the model were 80.98%and 90.20%respectively,and the AUC was 0.9208.The diagnostic model M2 could distinguish GS<60 from GS≥60in AMI with the sensitivity of 75.51%and specificity of 76.92%,respectively,and the AUC was 0.8014.The diagnostic model M3 has certain diagnostic value for UA.The sensitivity and specificity of M3 to distinguish healthy subjects from patients with unstable angina were 76.47%and 70.75%,respectively,and the AUC was 0.8019.3.G/M was positively correlated with the prognosis of the AMI.The better the prognosiswas,the G/M value was higher.Conclusions:1.Acute myocardial infarction and unstable angina have their own unique"glycan fingerprint"characteristics.2.Serum monosaccharides can be used to diagnose acute coronary syndrome;3.G/M can be preliminarily used to evaluate prognosis of AMI.