LPL相关ANGPTL及TMAVA与冠状动脉病变狭窄程度的关联性分析

孙幸; 范鲍函; 蔡玥; 沈童童

doi:10.16766/j.cnki.issn.1674-4152.004444

LPL相关ANGPTL及TMAVA与冠状动脉病变狭窄程度的关联性分析

doi: 10.16766/j.cnki.issn.1674-4152.004444

安徽医科大学附属滁州医院心血管内科, 安徽滁州 239001

基金项目:

安徽省卫生健康科研项目 AHWJ2024BAi30008

安徽医科大学校基金资助项目 2022xkj078

详细信息

通讯作者:
沈童童，E-mail：37024942@qq.com

中图分类号: R541.4
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出版历程
- 收稿日期: 2025-11-13

The relationship between lipoprotein lipase-related angiopoietin-like proteins and trimethyl-5-aminopentanoic acid with the severity of coronary artery stenosis

Department of Cardiovascular Medicine, the Affiliated Chuzhou Hospital of Anhui Medical University, Chuzhou, Anhui 239001, China

摘要

摘要: 目的探究脂蛋白脂肪酶(LPL)相关血管生成样素蛋白(ANGPTL)以及三甲基-5-氨基戊酸(TMAVA)与冠脉病变狭窄程度之间的相关性，从而为预测和诊治冠心病提供新的理论依据。方法连续选取2024年6月—2025年6月在安徽医科大学附属滁州医院行冠脉造影的270例患者进行Gensini评分(GS评分)，根据中位数划分为高分组(GS评分＞15.6分，110例)和非高分组(GS评分≤15.6分，160例)，再将非高分组划分为低分组(GS评分>0分~15.6分，49例)和正常组(GS评分=0分，111例)。比较高分组、低分组和正常组间基线资料；通过Spearman相关性分析探讨ANGPTL和TMAVA与GS评分之间的相关性；通过logistic回归分析研究影响冠心病发生的独立因素。结果高分、低分和正常组间糖尿病史、年龄、空腹血糖(FPG)、LDL-C、HDL-C和Non-HDL-C差异均有统计学意义(P < 0.05)。Spearman分析结果显示, ANGPTL3、4、8以及TMAVA均与GS评分呈正相关关系(r_s=0.754、0.348、0.749、0.762，均P < 0.001)。Logistic回归分析显示，ANGPTL3、ANGPTL4、ANGPTL8以及TMAVA浓度升高均为冠心病的独立危险因素[OR(95% CI)=1.614(1.435~1.864)、1.375(1.261~1.512)、14.488(6.643~36.374)、1.114(1.079~1.148)，均P < 0.001]。结论 LPL相关的ANGPTL和TMAVA不仅可作为评估冠状动脉病变程度的指标，而且可以早期识别冠心病患者。
- 冠心病 /
- 血管生成样素蛋白 /
- 三甲基-5-氨基戊酸 /
- Gensini评分 /
- 脂蛋白脂肪酶
Abstract: Objective To investigate the correlation between angiopoietin-like proteins (ANGPTLs) related to lipoprotein lipase (LPL) and trimethyl-5-aminovaleric acid (TMAVA) with the severity of coronary artery stenosis, thereby providing a novel theoretical basis for the prediction, diagnosis, and treatment of coronary heart disease. Methods A total of 270 patients who underwent coronary angiography at the Affiliated Chuzhou Hospital of Anhui Medical University from June 2024 to June 2025 were consecutively enrolled. Gensini scores were calculated, and patients were divided into a high-score group (GS score > 15.6, 110 cases) and a non-high-score group (GS score ≤ 15.6, 160 cases). Subsequently, the non-high-score group was further categorized into a low-score group (0 < GS score ≤ 15.6, 49 cases) and a normal group (GS score = 0, 111 cases). Baseline data of the high-score, low-score, and normal groups were compared. Spearman correlation analysis was employed to explore the correlation between ANGPTLs (angiopoietin-like proteins) and TMAVA (trimethyl-5-aminovaleric acid) with the GS (Gensini) score. Logistic regression analysis was conducted to identify independent influencing factors for the occurrence of coronary heart disease. Results There were statistically significant differences in the history of diabetes, age, fasting plasma glucose (FPG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and non-high-density lipoprotein cholesterol (Non-HDL-C) among the high-score, low-score, and normal groups (all P < 0.05). Spearman correlation analysis revealed that ANGPTL3, ANGPTL4, ANGPTL8, and TMAVA were all positively correlated with the GS (Gensini) score (r_s=0.754, 0.348, 0.749, 0.762, all P < 0.001). Logistic regression analysis indicated that elevated concentrations of ANGPTL3, ANGPTL4, ANGPTL8, and TMAVA were all independent risk factors for coronary heart disease [OR(95% CI)=1.614(1.435-1.864), 1.375(1.261-1.512), 14.488(6.643-36.374), 1.114(1.079-1.148), all P < 0.001]. Conclusion LPL-associated ANGPTLs and TMAVA can serve not only as indicators for evaluating the severity of coronary artery lesions but also as potential markers for early identification of patients with coronary heart disease.
- Coronary heart disease /
- Angiopoietin-like proteins /
- Trimethyl-5-aminovaleric acid /
- Gensini score /
- Lipoprotein lipase
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表 1 3组冠状动脉不同狭窄程度患者临床资料比较

Table 1. Comparison of clinical data among three groups of patients with different degrees of coronary artery stenosis

项目	正常组 (GS=0，n=49)	低分组 (0 < GS≤15.6，n=111)	高分组 (GS＞15.6，n=110)	统计量	P值
性别[例(%)]				1.004^a	0.605
男性	22(44.9)	53(47.7)	58(52.7)
女性	27(55.1)	58(52.3)	52(47.3)
年龄[M(P₂₅, P₇₅)，岁]	57.0(53.0, 63.0)	63.0(57.5, 70.5)	67.5(58.2, 74.0)	22.644^b	< 0.001
BMI[M(P₂₅, P₇₅)]	25.7(23.0, 27.4)	26.0(23.5, 28.0)	25.7(23.0, 28.3)	0.691^b	0.708
吸烟史[例(%)]	22(44.9)	53(47.7)	58(52.7)	1.004^a	0.605
既往病史[例(%)]
高血压	33(67.3)	74(66.7)	80(72.7)		0.589^c
糖尿病	9(18.4)	24(21.6)	39(35.5)	7.515^a	0.023
脑梗死	3(6.12)	14(12.6)	16(14.5)	2.269^a	0.322
实验室指标
FPG[M(P₂₅, P₇₅)，mmol/L]	5.84(5.32, 6.96)	5.82(5.20, 6.66)	6.06(5.48, 7.61)	7.355^b	0.025
LDL-C[M(P₂₅, P₇₅)，mmol/L]	2.49(2.12, 3.11)	2.39(1.87, 3.00)	2.88(2.13, 3.34)	10.149^b	0.006
HDL-C[M(P₂₅, P₇₅)，mmol/L]	1.09(0.87, 1.27)	1.12(0.96, 1.25)	1.00(0.83, 1.16)	10.697^b	0.005
Non-HDL-C[M(P₂₅, P₇₅)，mmol/L]	3.13(2.67, 3.74)	2.91(2.36, 3.83)	3.55(2.67, 4.04)	7.449^b	0.024
TC[M(P₂₅, P₇₅)，mmol/L]	4.33(3.74, 4.95)	4.18(3.37, 4.88)	4.52(3.67, 5.15)	3.723^b	0.155
TG[M(P₂₅, P₇₅)，mmol/L]	1.35(0.88, 2.04)	1.33(0.92, 1.72)	1.53(0.95, 1.98)	0.975^b	0.614
TyG[M(P₂₅, P₇₅)，mmol/L]	8.75(8.27, 9.14)	8.71(8.34, 9.09)	8.93(8.39, 9.27)	3.191^b	0.203
cTnI[M(P₂₅, P₇₅)，ng/mL]	0.27(0.21, 0.78)	0.29(0.21, 0.92)	0.29(0.20, 0.86)	0.099^b	0.952
CK-MB[M(P₂₅, P₇₅)，U/L]	10.40(8.90, 12.30)	10.25(8.03, 13.25)	11.30(8.80, 15.80)	3.195^b	0.202
注：^a为χ²值，^b为Z值, ^c为采用Fisher精确检验。

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表 2 冠心病影响因素的logistic回归分析

Table 2. Logistic regression analysis of influencing factors for coronary heart disease

变量	未调整模型		模型1		模型2
变量	OR(95% CI)	P值	OR(95% CI)	P值	OR(95% CI)	P值
ANGPTL3	1.571(1.423~1.783)	< 0.001	1.564(1.415~1.769)	< 0.001	1.614(1.435~1.864)	< 0.001
ANGPTL4	1.372(1.281~1.489)	< 0.001	1.359(1.263~1.482)	< 0.001	1.375(1.261~1.512)	< 0.001
ANGPTL8	13.454(6.878~29.253)	< 0.001	12.944(6.478~28.835)	< 0.001	14.488(6.643~36.374)	< 0.001
TMAVA	1.112(1.085~1.155)	< 0.001	1.113(1.084~1.145)	< 0.001	1.114(1.079~1.148)	< 0.001
注：未调整模型为未调整任何因素；模型1调整了年龄、性别和BMI；模型2调整了年龄、性别、BMI、高血压、糖尿病、FPG、LDL、HDL、非HDL、TG。

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表 3 冠心病患者血脂间共线性分析结果(n=270)

Table 3. Collinearity analysis of blood lipid levels in patients with coronary heart disease (n=270)

血脂变量	B	SE	β	t值	P值	共线性统计
血脂变量	B	SE	β	t值	P值	容忍度	VIF
LDL	0.211	0.103	0.363	2.045	0.042	0.114	8.748
HDL	-0.296	0.102	-0.222	-2.913	0.004	0.621	1.611
Non-HDL-C	-0.167	0.085	-0.362	-1.966	0.049	0.106	9.399
TG	-0.014	0.016	-0.056	-0.882	0.379	0.889	1.124
注：因变量为是否患有冠心病。

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