空腹血清总胆汁酸水平与冠状动脉疾病、心肌梗死和冠状动脉病变严重程度有关。
Fasting serum total bile acid level is associated with coronary artery disease, myocardial infarction and severity of coronary lesions.
机构信息
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, China.
出版信息
Atherosclerosis. 2020 Jan;292:193-200. doi: 10.1016/j.atherosclerosis.2019.11.026. Epub 2019 Nov 28.
BACKGROUND AND AIMS
Bile acids play important roles in lipid metabolism. Several studies have found that patients with coronary artery disease (CAD) have lower bile acid fecal excretion compared to individuals without CAD. However, few studies have focused on the roles of more accessible serum total bile acids (TBA) in the progression of CAD. The aim of this study was to explore the potential relationship between fasting serum TBA and the presence of CAD, myocardial infarction (MI) and severity of coronary lesions.
METHODS
A total of 7438 consecutive patients with suspected CAD, who had undergone coronary angiography, were enrolled. The severity of coronary lesions was evaluated using the Gensini score (GS). The relationships between fasting serum TBA and the presence and severity of CAD were evaluated.
RESULTS
CAD patients had lower serum TBA than individuals without CAD, and patients with MI had lower TBA than those without CAD. Spline analyses showed an L-shaped relationship of the fasting serum TBA with the presence and severity of CAD, and the breakpoint approximated the normal upper limit (10 μmol/L). A lower TBA concentration (less than the median 3.6 μmol/L) was independently and significantly associated with the presence and severity of CAD, especially for the presence of MI (odds ratios 2.04, 95% confidence interval (1.71-2.44), C-index 0.9269).
CONCLUSIONS
Fasting serum TBA level is highly associated with the presence and severity of CAD in patients undergoing coronary angiography for suspected CAD.
背景与目的
胆汁酸在脂质代谢中发挥重要作用。多项研究发现，与无 CAD 的个体相比，冠心病（CAD）患者的胆汁酸粪便排泄量较低。然而，很少有研究关注更易获得的血清总胆汁酸（TBA）在 CAD 进展中的作用。本研究旨在探讨空腹血清 TBA 与 CAD、心肌梗死（MI）和冠状动脉病变严重程度之间的潜在关系。
方法
共纳入 7438 例连续疑似 CAD 患者，行冠状动脉造影。采用 Gensini 评分（GS）评估冠状动脉病变严重程度。评估空腹血清 TBA 与 CAD、MI 存在及严重程度的关系。
结果
CAD 患者的血清 TBA 低于无 CAD 患者，MI 患者的 TBA 低于无 CAD 患者。折线分析显示，空腹血清 TBA 与 CAD 的存在和严重程度呈 L 型关系，拐点接近正常上限（10 μmol/L）。较低的 TBA 浓度（低于中位数 3.6 μmol/L）与 CAD 的存在和严重程度独立且显著相关，尤其是 MI 的存在（比值比 2.04，95%置信区间 1.71-2.44，C 指数 0.9269）。
结论
在因疑似 CAD 而行冠状动脉造影的患者中，空腹血清 TBA 水平与 CAD 的存在和严重程度高度相关。
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