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目的探讨稳定型冠心病患者血浆前蛋白转化酶枯草溶菌素9(PCSK9)与低密度脂蛋白(LDL)亚组分的相关性。方法连续入选未服用降脂药物治疗的稳定型冠心病患者281例,收集基线临床资料,采用ELISA方法检测血浆PCSK9水平、Lipoprint脂蛋白分类检测仪分析LDL亚组分。结果血浆PCSK9水平与中等颗粒LDL-C和小颗粒LDL-C浓度均呈正相关(分别为:r=0.145,p=0.015;r=0.166,p=0.005)。经多因素回归分析调整传统危险因素后,PCSK9水平与中等颗粒和小颗粒LDL-C浓度仍呈独立正相关(分别为β=0.152,p=0.013;β=0.179,p=0.004),与LDL颗粒大小呈显著负相关(β=-0.130,p=0.035)。进一步分析发现,上述相关性仅存在于男性冠心病患者。结论稳定型冠心病患者血浆PCSK9水平不仅与LDL-C浓度相关,且与LDL各亚组分具有相关性,提示PCSK9与LDL亚组分表型分布可能存在潜在相互作用。
Objective To investigate the relationship between plasma protein convertase subtilisin 9 (PCSK9) and low density lipoprotein (LDL) sub-components in patients with stable coronary heart disease. Methods A total of 281 stable coronary heart disease patients without lipid-lowering drugs were enrolled in this study. Baseline clinical data were collected. Plasma PCSK9 levels were measured by ELISA. LDL sub-components were analyzed by Lipoprint lipoprotein analyzer. Results Plasma PCSK9 levels were positively correlated with the concentrations of LDL-C and LDL-C (r = 0.145, p = 0.015, r = 0.166, p = 0.005). After adjustment for traditional risk factors by multi-factor regression analysis, the level of PCSK9 was still independently and positively correlated with the concentration of LDL-C in medium and small particles (β = 0.152, p = 0.013; β = 0.179, p = 0.004) There was a significant negative correlation between particle size (β = -0.130, p = 0.035). Further analysis found that the above correlation exists only in patients with coronary heart disease. Conclusions The plasma PCSK9 levels in patients with stable coronary heart disease are not only correlated with the concentration of LDL-C, but also with the sub-components of LDL, suggesting that there may be potential interactions between the PCSK9 and LDL sub-components.