血清ApoB/ApoA1比值对动脉粥样硬化临床诊断的价值

Diagnostic value of serum ApoB/ApoA1 ratio for atherosclerosis

目的探讨血清生物标记物载脂蛋白B(apolipoprotein B,ApoB)/载脂蛋白A1(ApoA1)比值对动脉粥样硬化临床预测价值。方法回顾分析2015-2018年参与体检的245名正常人与动脉粥样硬化患者的临床资料,包括性别、年龄、血压、体质量指数等数据。其中正常对照组85例,男性45例,女性40例;内膜增厚组87例,男性55例,女性32例;动脉粥样硬化斑块组73例,男性49例,女性24例。采用全自动生化分析仪检测相关生物标记物的血清学浓度,对ApoB/ApoA1和血脂相关指标进行ROC曲线分析和相关性分析。结果动脉粥样硬化组的ApoB/ApoA1比值为0.91±0.29,显著高于内膜增厚组的0.85±0.29和正常对照组的0.74 1±0.26(P均<0.05)。ROC分析提示:ApoB/ApoA1诊断动脉粥样硬化的AUC为0.77,敏感度为0.71,特异度为0.69,均高于其他单项指标。相关分析显示:ApoB/ApoA1比值与其他多个血脂指标均有显著性相关(P<0.05)。结论ApoB/ApoA1比值可以作为评估临床动脉粥样硬化发生风险的生物标记物组合指标。

Objective To assess the value of serum ApoB/ApoAl ratio in the diagnosis of atherosclerosis.Methods Clinical data(including sex,age,blood pressure,BMI,etc.)about 245 middle-aged and elderly people who underwent health-check in our hospital from 2015 to 2018 were retrospectively analyzed.Of the 245 cases,85 cases were in healthy control group,including 45 males and40 females;87 cases were in increased intima-media thickness(IMT)group(1.0 ≤ IMT<1.1 mm)with 55 males and 32 females;73 cases were in plaque group(IMT ≥ 1.2 mm)group,with 49 males and 24 females.The serum concentration of the biomarkers was measured by the automatic bioanalyzer,and ApoB/ApoAl and blood lipid related indicators were analyzed by ROC curve analysis and correlation analysis.Results The ApoB/ApoAl ratio in atherosclerosis group was significantly higher than that in IMT group and normal group(0.91±0.29 vs 0.85±0.29 and 0.74±0.26,P<0.05,respectively).ROC analysis suggested that the AUC was 0.77 with sensitivity of 0.71 and specificity of 0.69 for ApoB/ApoAl ratio in prediction of atherosclerosis,which was significantly higher than other indicators.Correlation analysis showed that ApoB/ApoAl ratio was significantly correlated with blood lipid related indicators(all P<0.05).Conclusion The ApoB/ApoAl ratio can be used as a biomarker for clinical evaluation of atherosclerosis.