Abstract
Background
Atherosclerosis cardiovascular diseases (ASCVD) are the leading cause of mortality and morbidity in patients with diabetes. But there are still no simpler and more effective biomarkers which can predict the severity of coronary atherosclerosis in diabetic patients. Oxidized low-density lipoprotein (oxLDL) is a novel CVD biomarker that also increase in diabetic patients. The aim of present study was to evaluate the associations of circulating oxLDL/LDL-C ratio with severity of coronary atherosclerosis and other emerging biomarkers of cardiovascular disease such as fibroblast growth factor 21 (FGF21), interleukin 33 (IL33) and vascular cell adhesion molecule-1 (VCAM-1) in patients with type 2 diabetes.
Methods
152 patients with type 2 diabetes were recruited in our study. Plasma levels in oxLDL, FGF21, IL33 and VCAM-1 were measured by ELISA. oxLDL/LDL-C ratio was calculated. Coronary computed tomographic angiography (CCTA) was performed in all patients. Patients were allocated into four groups according to CCTA findings and Gensini score: normal, mild, moderate and severe coronary atherosclerosis group. Association between the oxLDL/LDL-C ratio and the severity of coronary atherosclerosis were evaluated using logistic regression models and receiver operator characteristic (ROC) curve analyses.
Results
Correlation analysis showed that oxLDL/LDL-C ratio was positively associated with severity of coronary atherosclerosis (p < 0.05). After adjusted for age, duration of diabetes, the positive correlation between severity of coronary atherosclerosis and oxLDL/LDL-C ratio still existed (OR 2.03, 95% CI 1.31- 3.14, p < 0.01). OxLDL/LDL-C ratio in severe group was significantly higher than which in the other three groups respectively (p< 0.001). The cut-off value of oxLDL/LDL-C ratio in predicting severe coronary atherosclerosis was more than 0.091 with specificity of 66.5% and sensitivity of 75%. Only IL33 correlated positively with oxLDL/LDL-C ratio (r = 0.274, p<0.01). However, VCAM-1 had a similar trend with oxLDL/LDL-C ratio in these four groups.
Conclusions
OxLDL/LDL-C ratio is considered as a potential biomarker in diabetic patients for early recognition and intervention of severe coronary atherosclerosis, and will be more effective if tested IL33 and VCAM-1 at the same time.
Accumulation of oxidized LDL in human semilunar valves correlates with coronary atherosclerosis