Key result
Low HDL-associated PON1 and PON3 are linked to ~168% greater CAD severity with high apoA-I glycation.
Why the study?
Are elevated apoA-I glycation and reduced HDL-associated PON1 and PON3 activities associated with angiographic severity of CAD in patients with T2DM?
Cross-Sectional (n=205)
No
Are elevated apoA-I glycation and reduced HDL-associated PON1 and PON3 activities associated with angiographic severity of CAD in patients with T2DM?
Effect estimate: 1.97- to 2.49-fold increase in extent index and 1.73- to 2.68-fold increase in CCSS
p-value: p=<0.01
Elevated apoA-I glycation and decreased HDL-associated PON1 and PON3 activities are associated with increased angiographic severity of CAD in patients with T2DM.
May link apoA-I glycation and PON activities to CAD severity in T2DM; leaves open causal role or biomarker utility.
OBJECTIVE: To investigate whether apolipoprotein A (apoA)-I glycation and paraoxonase (PON) activities are associated with the severity of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). METHODS: Relative intensity of apoA-I glycation and activities of high-density lipoprotein (HDL)-associated PON1 and PON3 were determined in 205 consecutive T2DM patients with stable angina with (n = 144) or without (n = 61) significant CAD (luminal diameter stenosis ≥ 70 %). The severity of CAD was expressed by number of diseased coronary arteries, extent index, and cumulative coronary stenosis score (CCSS). RESULTS: The relative intensity of apoA-I glycation was higher but the activities of HDL-associated PON1 and PON3 were lower in diabetic patients with significant CAD than in those without. The relative intensity of apoA-I glycation increased but the activities of HDL-associated PON1 and PON3 decreased stepwise from 1 - to 3 - vessel disease patients (P for trend < 0.001). After adjusting for possible confounding variables, the relative intensity of apoA-I glycation correlated positively, while the activities of HDL-associated PON1 and PON3 negatively, with extent index and CCSS, respectively. At high level of apoA-I glycation (8.70 ~ 12.50 %), low tertile of HDL-associated PON1 (7.03 ~ 38.97U/mL) and PON3 activities (7.11 ~ 22.30U/mL) was associated with a 1.97- and 2.49- fold increase of extent index and 1.73- and 2.68- fold increase of CCSS compared with high tertile of HDL-associated PON1 (57.85 ~ 154.82U/mL) and PON3 activities (39.63 ~ 124.10U/mL), respectively (all P < 0.01). CONCLUSIONS: Elevated apoA-I glycation and decreased activities of HDL-associated PON1 and PON3, and their interaction are associated with the presence and severity of CAD in patients with T2DM.
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Shen et al. (2015) conducted a cross-sectional in Type 2 diabetes mellitus with stable angina (n=205). Elevated apoA-I glycation and reduced HDL-associated PON1 and PON3 activities vs. Low apoA-I glycation and high HDL-associated PON1 and PON3 activities was evaluated on Severity of coronary artery disease (extent index and cumulative coronary stenosis score) (1.97- to 2.49-fold increase in extent index and 1.73- to 2.68-fold increase in CCSS, p=<0.01). At high levels of apoA-I glycation, low tertiles of HDL-associated PON1 and PON3 activities were associated with up to a 2.49-fold increase in extent index and 2.68-fold increase in cumulative coronary stenosis score.
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