Association of elevated apoA-I glycation and reduced HDL-associated paraoxonase1, 3 activity, and their interaction with angiographic severity of coronary artery disease in patients with type 2 diabetes mellitus

Ying Shen, Feng Hua Ding, Jia Teng Sun, Li Jin Pu, Rui Yan Zhang, Qi Zhang, Qiu Jing Chen, Wei Feng Shen, Lin Lu, Ying Shen, Feng Hua Ding, Jia Teng Sun, Li Jin Pu, Rui Yan Zhang, Qi Zhang, Qiu Jing Chen, Wei Feng Shen, Lin Lu

Abstract

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.

Figures

Figure 1
Figure 1
Extent index and cumulative coronary stenosis score in relation to apoA-I glycation and HDL-associated activities of PON1 and PON3. Tertiles of HDL-associated activities of PON1 (●low [7.03 ~ 38.97 U/mL], ■middle [40.37 ~ 57.17 U/mL], ♦high [57.85 ~ 154.82 U/ml]) and PON3 (○low [7.11 ~ 22.30 U/mL], □middle [23.12 ~ 39.57 U/mL], ◊high [39.63 ~ 124.10 U/mL]).*P < 0.05, **P < 0.01, ***P < 0.001 vs. low tertile of activities of PON1 or PON3; #P < 0.05, ##P < 0.01 vs. middle tertile of activities of PON1 or PON3

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