Objective
To explore the association between carotid artery plaque and small dense low-density lipoprotein cholesterol (sdLDL-C) concentrations as well as the probability of sdLDL-C and sdLDL-C/LDL-C ratio as biomarkers of human carotid atherosclerotic plaque.
Methods
174 subjects in physical examination center of An Zhen Hospital from November 2015 to February 2016 were enrolled one by one as a cross-sectional study. All subjects were divided into carotid IMT abnormal group (n=92) and control group(n=82)according to carotid ultrasound. According to the thickness of IMT characterized by carotid ultrasound, subjects were divided into the thickened IMT group(n=32), plaques group(n=60), and plaques group were divided into single plaque group(n=33) and multiple plaques group(n=27). Body Mass Index(BMI), fasting serum sdLDL-C, triglyceride(TG), LDL-C and high-density lipoprotein cholesterol (HDL-C) concentrations were measured. Pearson′s and Spearman correlation coefficient analyses and logistic regression analyses were used to examine the relationships between carotid atherosclerotic plaque, sdLDL-C values, and other clinical variables. Area under curve(AUC) was calculated to determine the diagnostic value of sdLDL-C and sdLDL-C/LDL-C ratio in subjects with carotid atherosclerotic plaque.
Results
Levels of sdLDL-C(1.02±0.42 vs. 0.97±0.46 vs. 0.61±0.29, F=21.07, P<0.001) and sdLDL-C /LDL-C(0.34±0.17 vs. 0.34±0.17 vs. 0.21±0.09, F=16.34, P<0.001) in the thickened IMT group and the plaques group were higher than those of the control group). Even in individuals considered to be at low LDL-C (<2.59 mmol/L) level, sdLDL-C(0.94±0.41 vs. 0.56±0.25, t=4.00, P<0.01) and sdLDL-C/LDL-C ratio(0.43±0.19 vs. 0.24±0.08, t=4.45, P<0.01) remained higher in the carotid abnormal group than those in the control group. Age and sdLDL-C were the independent risk factors of carotid artery plaque. AUC of receiver operator characteristic curve (ROC) for serum sdLDL-C and sdLDL-C/LDL-C ratio were 0.882(95% CI: 0.819-0.945, P<0.01) and 0.830(95% CI: 0.747-0.914, P<0.01) to determine the multiple carotid atherosclerotic plaque, and the cut-off level were 0.90 mmol/L (sensitivity, 88.0%; specificity, 79.3%) and 0.30 (sensitivity, 84.0%; specificity, 74.5%).
Conclusions
Carotid atherosclerotic plaque has a close relationship with sdLDL-C concentrations. sdLDL-C and sdLDL-C/LDL-C ratio can be biomarkers when assessing subjects with a carotid atherosclerotic plaque.(Chin J Lab Med, 2018, 41: 219-226)
Key words:
Carotid artery diseases; Plaque, atherosclerotic; Cholesterol, LDL; Biomarkers
Abstract Background We validated the performance of seven different reagents of peroxidase method for sdLDL‐C in two automatic analyzers that are common in Chinese laboratories. Methods Seven commercially available sdLDL‐C assays were analyzed with the Beckman AU5400 and Mindray BS2000 automatic analyzers. A total of 336 blood samples were collected and the reference interval was also validated in 298 apparently healthy individuals. Serum samples were used for method comparison of precision, recovery, lower limit of detection, comparison and concurrence analysis, as well as reference interval for the Mindray reagent. Results The repeatability CV% of the seven sdLDL‐C assays were 0.81%~3.66% for Mindray BS2000 and 0.76%~3.91% for Beckman AU5400, while Total CVs for Mindray BS2000 sdLDL‐C assay were 1.34%~4.81%, and that of Beckman AU5400 were 2.25%~10.33%. The measured recovery rates of sdLDL‐C assays were within the allowable ±10% deviation range. There was no obvious difference between the reagents in the lower limit detection. There was a difference between the validation results of the reference range and the manufacturer's.BSBE, Mindray, and Dongou had a high degree of association with DENKA SEIKEN on Mindray BS2000, while BSBE, Mindray, Dongou and Merit Choice had a high degree of association with DENKA SEIKEN on Beckman AU5400. Passing–Bablok regression showed excellent linear correlation between BSBE and Mindray and DENKA SEIKEN and on Beckman AU5400. Conclusions Our results indicate that the basic performance can meet the testing requirements, but the comparability between them is still insufficient.
The early identification of heart failure (HF) risk may favorably affect outcomes, and the combination of multiple biomarkers may provide a more comprehensive and valuable means for improving the risk of stratification. This study was conducted to assess the importance of individual cardiac biomarkers creatine kinase MB isoenzyme (CK-MB), B-type natriuretic peptide (BNP), galectin-3 (Gal-3) and soluble suppression of tumorigenicity-2 (sST2) for HF diagnosis, and the predictive performance of the combination of these four biomarkers was analyzed using random forest algorithms.A total of 193 participants (80 patients with HF and 113 age- and gender-matched healthy controls) were included from June 2017 to December 2017. The correlation and regression analysis were conducted between cardiac biomarkers and echocardiographic parameters. The accuracy and importance of these predictor variables were assessed using random forest algorithms.Patients with HF exhibited significantly higher levels of CK-MB, BNP, Gal-3, and sST2. BNP exhibited a good independent predictive capacity for HF (AUC 0.956). However, CK-MB, sST2, and Gal-3 exhibited a modest diagnostic performance for HF, with an AUC of 0.709, 0.711, and 0.777, respectively. BNP was the most important variable, with a remarkably higher mean decrease accuracy and Gini. Furthermore, there was a general increase in predictive performance using the multi-marker model, and the sensitivity, specificity was 91.5% and 96.7%, respectively.The random forest algorithm provides a robust method to assess the accuracy and importance of predictor variables. The combination of CK-MB, BNP, Gal-3, and sST2 achieves improvement in prediction accuracy for HF.
Background: The reference intervals (RIs) of adult blood lipid parameters currently used in China are not derived from the results of research in local populations and have not been adjusted for age and sex. In this study, we aimed to determine accurate RIs for blood lipid parameters and blood glucose (GluG) for Chinese adults using a national multicenter study. Methods: A total of 11,333 adults between 18 and 90 years of age were recruited in seven representative regions in China between June 2020 and December 2020. Hospitals participating in the study were regrouped into two geographical regions, southern China (Changsha, Chengdu, Hangzhou, and Nanning) and northern China (Beijing, Shenyang, and Ningxia), according to their geographical and administrative location. All samples were freshly collected and measured collectively in one laboratory on the Mindray full Automatic biochemical analyzer chemistry BS2000 analytical systems. Outliers were removed using the Tukey test. Three-level nested analysis of variance and scatter plot were used to explore the variations in sex, age, and region. Percentile curves of each indicator were plotted using the least mean square (LMS) method. The lower limit (2.5th percentile) and the upper limit (97.5th percentile) of the RI were determined by using nonparametric statistical methods. We also calculated the 90% confidence interval (CI) for the lower and upper limits. Results: A total of 8,283 participants were enrolled in the final analysis, with 3,593 (43.4%) men and 4,690 (56.6%) women. Regionality was observed in three analytes [small dense low density lipoprotein cholesterol (sd-LDLC), GluG, and apolipoprotein A1 (ApoA1)]. In northern China, the sd-LDLC and GluG levels in Shenyang were significantly higher than those in Ningxia and Beijing (P<0.05). In southern China, the sd-LDLC and GluG levels in Nanning were significantly higher than those in the three other cities (P<0.05), whereas the sd-LDLC and GluG levels in Chengdu were significantly lower than those in the three other cities (P<0.05). The level of ApoA1 in Chengdu was significantly higher than that in the three other cities. The homocysteine (HCY) level in male participants was clearly higher than that in female participants [ratio of standard deviation (SDR)sex =0.56], whereas the levels of high density lipoprotein cholesterol (HDLC) (SDRsex =0.40) and ApoA1 (SDRsex =0.27) in males were lower. The GluG and HCY level increased gradually with age. In females aged 45–55 years, there was an interesting change in scatter charts, where triglyceride (TG) and total cholesterol (TC) increased rapidly. We also found that for the age group of >55 years, the levels of TG and TC in females gradually surpassed those in males. Conclusions: The findings of this study may help establish age- and sex-specific reference values for the blood lipids of Chinese adults and serve as a valuable guide for the screening, diagnosis, treatment, prevention, and monitoring of cardiovascular disease (CVD).
Platelets play an important role in the pathophysiology of coronary artery disease. However, the clinical value of platelet indices in premature coronary heart disease remains largely unknown.Consecutive patients referred for coronary angiography were evaluated (n = 1675). Patients were stratified into premature coronary heart disease (n = 679, age < 55 for male and age < 65 for female), late-onset coronary heart disease (n = 772, age ≥ 55 for male and age ≥ 65 for female), and control (n = 224, age < 55 for male and age < 65 for female). Their clinical and laboratory parameters were collected. The relationship between platelet indices and premature coronary artery disease was analyzed.In univariate analysis, platelet indices showed no significant association with the presence of premature coronary heart disease (P > 0.05). After adjustment for traditional risk factors, mean platelet volume (0.823 [0.683-0.993], P = 0.042) and platelet-large cell ratio (0.976 [0.954-0.999], P = 0.040) were negatively correlated with the presence of premature coronary heart disease. The platelet-to-lymphocyte ratio was statistically significant among different numbers of coronary lesions (P = 0.035). In subgroup analysis, platelet-large cell ratio (1.190 [1.010-1.403], P = 0.038) was an independent risk factor of coronary restenosis after percutaneous coronary intervention.Platelet indices were associated with the prevalence, severity, and coronary restenosis after percutaneous coronary intervention suggesting their possible clinical application in premature coronary heart disease.
To analyze the genetic characterization of epidemic rubella virus strains isolated in Liaoning from 2007-2012, a total of 145 rubella virus strains were isolated using Vero/Slam cell line from the patients' throat swabs during rubella outbreaks and sporadics cases in Liaoning Province from 2007 to 2012. Fragments of 945 nucleotides containing 1E gene from 145 rubella virus isolates were amplified by RT-PCR, the PCR products were sequenced and analyzed. Based on the 739 nucleotides of 1E gene, the phylogenetic trees were constructed with 32 WHO rubella reference strains of 13 genotypes downloaded from GenBank and 145 rubella virus strains. The results showed that the 145 rubella virus strains in 2007 -2012 belonged to genotype 1E, nucleotide acids and amino acids similarities were 97.2%-100.0% and 97.6%-100.0%, respectively. Compared to the 1E reference strains(Rvi/ Dezhou.CHN/02, RVi/MYS/01), the nucleotide acids and amino acids similarities were 96.6%-99.2% and 98.2%-100.0%, respectively except for one amino acid change (Val246-Ala246) of RVi/Shenyang. Liaoning. CHN/13.11/13, and Asp262-Asn262 of RVi/Shenyang. Liaoning. CHN/13.11/4 and RVi/Liaoyang. Liaoning. CHN/26. 11/2. there had no change found in the important antigenic epitope sites, the hemagglutination inhibition and neutralization epitopes of the other rubella viruses. All the 145 strains isolated had the same amino acid change (Leu338--Phe338) in E1 protein. These findings suggested that genotype 1E of rubella virus was the predominant genotype in Liaoning province. the rubella prevailed in recent six years was mainly caused by rubella viruses genotype 1E with multi-transmission routes.
Objective
The study aimed to investigate the clinical value of serum soluble ST2(sST2) and galectin-3(gal-3) in dilated cardiomyopathy(DCM) patients associated with heart failure.
Methods
60 DCM patients with heart failure were collected in Anzhen Hospital Department of Cardiology from June to December 2017 as researching group. 52 coronary heart disease(CHD) patients with heart failure were as the controls, also, 70 healthy controls were analyzed by cross-sectional investigation. In DCM group, 18 patients (male/female:11/7) were enrolled in the NYHA(New York Heart Association) cardiac function Ⅰ-Ⅱ group and 42 patients (male/female: 32/10) were enrolled in the NYHA cardiac function Ⅲ-Ⅳ group. sST2 was detected by enzyme-linked immunoassay; gal-3 was detected by chemiluminescence immunoassay. One-Way ANOVA, non-parametric test, Spearman linear correlation analysis and other statistical methods were used in our study.
Results
Compared with healthy controls, the serum level of sST2 in DCM group increased markedly [21.23(14.59,25.29) ng/ml vs 14.59(12.78,17.16) ng/ml, standardized H=-4.645,adjusted P<0.001], and significantly higher serum level of gal-3 [13.50(10.48,19.68)μg/L vs 10.05(8.25, 12.80) μg/L, standardized H=4.266, adjusted P<0.001]. Compared with CHD group, there was a significant increase [13.50(10.48, 19.68) μg/L vs 11.00(8.65, 13.58) μg/L, standardized H=-2.715, adjusted P=0.020] in the expression of serum gal-3 in DCM group. The serum level of sST2 in cardiac function Ⅲ-Ⅳ group was obviously higher than that in the Ⅰ-Ⅱ group [22.54(16.82,26.78)ng/ml vs 12.24(9.22,17.79) ng/ml, Z=2.613,P=0.009].Spearman correlation analysis showed a negative correlation between sST2 and left ventricular ejection fraction(LVFE)(r=-0.647, P<0.01), but a positive correlation between left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic dimension(LVESD)(r=0.393,r=0.462,all P<0.01). The correlation of sST2 and B-type natriuretic peptide(BNP)/gal-3 (r=0.320,r=0.331,all P<0.05),gal-3 and high-sensitivity troponinI(hs-TnI)/BNP(r=406,r=0.401,all P≤0.01) presented the same. There was a inverse correlation between gal-3 and estimated glomerular filtration rate(eGFR)(r=-0.326,P<0.05).ROC analysis showed that the cutoff of sST2 was 21.00 ng/ml, with 51.9% sensitivity and 95.7% specificity (AUC=0.745,95% CI:0.652-0.838,P<0.001), and the cutoff of gal-3 was 13.15 μg/L, with 53.7% sensitivity and 85.7% specificity (AUC=0.720,95% CI:0.627-0.812,P<0.001). Combined detection of BNP/hs-TnI may remarkably improved the sensitivity (up to 95.3%).
Conclusions
The serum levels of sST2 and gal-3 were significantly increased in dilated cardiomyopathy patients with heart failure. It showed a strong relation between sST2 and the deterioration of cardiac function, and a certain correlation with left ventricular remodeling. Although the diagnostic value of DCM was lower than that of BNP, sST2 may not be affected by age, body mass index and the damage to kidney function. Combined diagnosis could dramatically improve the diagnostic efficacy.
Key words:
Cardiomyopathy, dilated; Interleukin-1 receptor-like 1 protein; Galectin 3
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