Nghiên cứu sự biến đổi nồng độ LP-PLA2, APO A-I, APO B, tỷ số APO B/APO A-I huyết thanh trong bệnh động mạch vành
Nội dung chính của bài viết
Tóm tắt
Lipoprotein-associated phospholipase A2, apolipoprotein A-I, apolipoprotein B đã được chứng minh tham gia vào quá trình hình thành các mảng xơ vữa động mạch trong bệnh động mạch vành. Mặt khác, tỷ số apo B/apo A-I còn thể hiện sự cân bằng giữa các hạt cholesterol giàu apo B gây xơ vữa và các hạt cholesterol giàu apo A-I chống xơ vữa. Nghiên cứu sự biến đổi nồng độ Lp-PLA2, apo A-I, apo B, tỷ số apo B/apo A-I huyết thanh ở 105 đối tượng có bệnh động mạch vành với mức độ hẹp động mạch vành ≥ 50% (nhóm bệnh) và 110 đối chứng. Kết quả: Nhóm bệnh có nồng độ Lp-PLA2, apoB, tỷ số apo B/apo A-I cao hơn nhóm chứng và nồng độ apo A-I thấp hơn nhóm chứng (p < 0,001). Phối hợp Lp-PLA2, apo A-I và apo B cho giá trị tốt nhất trong chẩn đoán mức độ nghiêm trọng của bệnh động mạch vành với AUC là 0,986 (khoảng tin cậy 95%:0,974 - 0,997), độ nhạy 98,1%, độ đặc hiệu 90,9%. Vì vậy, nồng độ Lp-PLA2, apo A-I, apo B có thể có giá trị cao trong dự báo sớm nguy cơ xơ vữa và chẩn đoán mức độ nghiêm trọng của bệnh động mạch vành.
Chi tiết bài viết
Từ khóa
apo A-I, apo B, Lp-PLA2, bệnh động mạch vành
Tài liệu tham khảo
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23. Zhang H, Gao Y, Wu D, Zhang D. The relationship of lipoprotein-associated phospholipase A2 activity with the seriousness of coronary artery disease. BMC Cardiovasc Disord. 2020;20. doi:10.1186/s12872-020-01580-4.
2. Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J Epidemiol Glob Health. Published online January 2021. doi:10.2991/jegh.k.201217.001.
3. Nguyễn Ngọc Quang. Dự phòng bệnh tim mạch đúng cách - Bệnh không lây. Sở Y Tế Hà Nội. 2019.
4. Fan R, Zhang N, Yang L, Ke J, Zhao D, Cui Q. AI-based prediction for the risk of coronary heart disease among patients with type 2 diabetes mellitus. Sci Rep. 2020;10(1):14457. doi:10.1038/s41598-020-71321-2.
5. Skelly AC, Hashimoto R, Buckley DI, et al. Noninvasive Testing for Coronary Artery Disease. Agency for Healthcare Research and Quality (US); 2016. Accessed March 28, 2021.
6. David I Feldman, Richard A Ferraro, Garima Sharma. Determining the Role of Coronary Artery Disease Severity Measured by Coronary CTA in ASCVD Risk Management. Am Coll Cardiol. Published online July 20, 2020.
7. Koenig Wolfgang, Twardella Dorothee, Brenner Hermann, Rothenbacher Dietrich. Lipoprotein-Associated Phospholipase A2 Predicts Future Cardiovascular Events in Patients With Coronary Heart Disease Independently of Traditional Risk Factors, Markers of Inflammation, Renal Function, and Hemodynamic Stress. Arterioscler Thromb Vasc Biol. 2006;26(7):1586-1593. doi:10.1161/01.ATV.0000222983.73369.c8.
8. Maiolino G, Bisogni V, Rossitto G, Rossi GP. Lipoprotein-associated phospholipase A2 prognostic role in atherosclerotic complications. World J Cardiol. 2015;7(10):609-620. doi:10.4330/wjc.v7.i10.609.
9. Sg S, S S, A B, et al. The role of Lp-PLA2 and biochemistry parameters as potential biomarkers of coronary artery disease in Asian South-Indians: a case-control study. Cardiovasc Diagn Ther. 2017;7(6):589-597. doi:10.21037/cdt.2017.08.13.
10. Kocak S, Ertekin B, Girisgin AS, et al. Lipoprotein-associated phospholipase-A2 activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke. Turk J Emerg Med. 2016;17(2):56-60. doi:10.1016/j.tjem.2016.10.001.
11.Colley KJ, Wolfert RL, Cobble ME. Lipoprotein associated phospholipase A2: role in atherosclerosis and utility as a biomarker for cardiovascular risk. EPMA J. 2011;2(1):27-38. doi:10.1007/s13167-011-0063-4.
12. Opoku S, Gan Y, Fu W, et al. Prevalence and risk factors for dyslipidemia among adults in rural and urban China: findings from the China National Stroke Screening and prevention project (CNSSPP). BMC Public Health. 2019;19(1):1500. doi:10.1186/s12889-019-7827-5.
13. Feingold KR. Introduction to Lipids and Lipoproteins. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. MDText.com, Inc.; 2000. Accessed March 24, 2021.
14. Schmidt C, Fagerberg B, Wikstrand J, Hulthe J. apoB/apoA-I ratio is related to femoral artery plaques and is predictive for future cardiovascular events in healthy men. Atherosclerosis. 2006;189(1):178-185. doi:10.1016/j.atherosclerosis.2005.11.031.
15. Schianca GPC, Pedrazzoli R, Onolfo S, et al. ApoB/apoA-I ratio is better than LDL-C in detecting cardiovascular risk. Nutr Metab Cardiovasc Dis. 2011;21(6):406-411. doi:10.1016/j.numecd.2009.11.002.
16. Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy – a review of the evidence. J Intern Med. 2006;259(5):493-519. doi:10.1111/j.1365-2796.2006.01643.x.
17. N.S. Dange, , Abhay Nagdeote, , kedar Deshpande. Serum apolipoprotein AI & B, lipoprotein, lipids levels in Indian patients with angiographically defined coronary artery disease. Int J Pharm Biol Sci. 2011;1(3):255-264.
18. Wilensky RL, Macphee CH. Lipoprotein-associated phospholipase A(2) and atherosclerosis. Curr Opin Lipidol. 2009;20(5):415-420. doi:10.1097/MOL.0b013e3283307c16.
19. Cai A, Zheng D, Qiu R, Mai W, Zhou Y. Lipoprotein-associated phospholipase A2 (Lp-PLA(2)): a novel and promising biomarker for cardiovascular risks assessment. Dis Markers. 2013;34(5):323-331.doi:10.3233/DMA-130976.
20. Alexander Thompson, Pei Gao, Lia Orfei. Lipoprotein-associated phospholipase A2 and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies - The Lancet. The Lancet. Published online 2010.
21. Sáez Y, Vacas M, Santos M, et al. Relation of High-Density Lipoprotein Cholesterol and Apoprotein A1 Levels with Presence and Severity of Coronary Obstruction. ISRN Vasc Med. 2012;2012:e451730. doi:10.5402/2012/451730.
22. Hong L-F, Yan X-N, Fan Y, et al. Is the ratio of apoB/apoA-1 the best predictor for the severity of coronary artery lesions in Chinese diabetics with stable angina pectoris? An assessment based on Gensini scores. J Geriatr Cardiol JGC. 2015;12(4):402-409. doi:10.11909/j.issn.1671-5411.2015.04.012.
23. Zhang H, Gao Y, Wu D, Zhang D. The relationship of lipoprotein-associated phospholipase A2 activity with the seriousness of coronary artery disease. BMC Cardiovasc Disord. 2020;20. doi:10.1186/s12872-020-01580-4.