对氧磷酶-3和糖氧化载脂蛋白A-I与糖尿病并发冠心病的关系

The Association of PON3 and Glycoxidative apoA-I with Type 2 Diabetes Complicated with Coronary Artery Disease

目的:探讨血清对氧磷酶-3(PON3)和载脂蛋白A-I(apoA-I)糖氧化水平与2型糖尿病(T2DM)并发冠心病(CAD)及其严重程度的关系。方法:202例T2DM患者按其是否合并CAD分为单纯糖尿病组(DM组,n=60)和T2DM合并CAD组(DM并CAD组,n=142),后者进一步按病变累及冠脉支数分为1支病变组(n=40),2支病变组(n=52)和3支病变组(n=50)。另选62例健康受试者为对照组。采用ELISA测定各组血清PON3水平;超速离心全血获得高密度脂蛋白(HDL),采用SDS-PAGE电泳分离apoA-I,免疫印迹分析apoA-I糖氧化水平。分析PON3水平和apoA-I糖氧化水平与冠脉病变程度的相关性。结果:DM并CAD组和3支病变组血清PON3水平(1.52±1.14ng/ml、1.31±1.09ng/ml)分别显著低于DM组(1.98±1.04ng/ml,P<0.05)、对照组(2.46±1.01ng/ml,P<0.05)和1支病变组(1.74±1.19ng/ml,P<0.05)。apoA-I糖氧化水平是CAD及其病变严重程度的独立预测因子,并与冠脉病变严重程度指数、病变冠脉支数呈显著正相关(r分别为0.611、0.549,P均<0.01)PON3水平与apoA-I糖氧化水平呈负相关(r=-0.388,P<0.01),且两者均为CAD独立预测因素。结论:低PON3水平与apoA-I糖氧化水平相关,后者与T2DM患者并发CAD及其严重程度相关。

Objective：To explore the association of serum paraoxonase-3 （PON3 ）and glycoxidative apoA-I levels with type 2 diabetes（T2DM）complicated with coronary artery disease（CAD）.Method：202 T2DM patients were divided into T2DM without CAD group （n=60）and T2DM with CAD group（n=142）,the latter was further classified with respect to the number of diseased coronary arteries as 1-vessel disease group（n=40）,2-vessel disease group （n=52）and 3-vessel disease group（n=50）,62 healthy subjects were served as control group.Serum PON3 levels were measured with ELISA.HDL proteins after ultracentrifugation were separated by SDS-polyacrylamide. Glycoxidative levels of apoA-I were analyzed by Western blot.Results：Serum PON3 levels were significantly lower in T2DM with CAD group （1.52±1.14ng/ml）and in patients with 3-vessel disease （1.31±1.09ng/ml）than those in T2DM）without CAD group （1.98±1.04ng/ml,P〈0.05）and controls （2.46±1.01ng/ml,P〈0.05）and 1-vessel disease group （1.74±1.19ng/ml,P〈0.05）,respectively.Glycoxidative level of apoA-I was an independent risk factor for the presence and severity of CAD,and positively correlated with QCA-derived extent index （Pearson’s,r=0.611）,the number of diseased coronary arteries （Spearman’s,r=0.549）,all P〈0.01）,respectively.Serum＆amp;nbsp;PON3 level was negatively correlated with glycoxidative level of apoA-I（Pearson’s,r=-0.388,P〈0.01）,both were independently associated with the presence of CAD.Conclusion：Reduced level of PON3 is associated with glycoxi-dative level of apoA-I.apoA-I glycoxidative level is associated with the presence and severity of CAD in T2DM patients.