PMID- 36397150 OWN - NLM STAT- MEDLINE DCOM- 20221123 LR - 20230108 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 21 IP - 1 DP - 2022 Nov 17 TI - Clinical significance of neutrophil gelatinase-associated lipocalin and sdLDL-C for coronary artery disease in patients with type 2 diabetes mellitus aged >/= 65 years. PG - 252 LID - 10.1186/s12933-022-01668-5 [doi] LID - 252 AB - BACKGROUND AND AIMS: Although type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) share many common pathological and physiological characteristics, there are few studies assessing the predictive capacity of novel biomarkers in occurrence and development of CAD in T2DM patients aged >/= 65 years. In addition, T2DM patients aged >/= 65 years are prone to CAD. Therefore, it is of great significance to find novel biomarkers for the development CAD in T2DM. METHODS: In this retrospective cohort study, 579 T2DM patients aged >/= 65 years were consecutively enrolled in this work, and 177 of whom had major adverse cardiovascular and cerebrovascular events (MACCE: cardiovascular or cerebrovascular death, acute coronary syndrome, coronary stent implantation, and stroke) during the follow up. Univariate and multivariate factors were employed to analyze the correlation between each variable and the occurrence of MACCE, and the Spearman's rank correlation analysis was performed to assess the relationships between Neutrophil gelatinase-associated lipocalin (NGAL) and small dense low-density lipoprotein-cholesterol (LDL-C) (sdLDL-C). The receiver operating characteristic (ROC) curve was adopted to determine the predictive value of NGAL and sdLDL-C elevation for MACCE in T2DM patients aged >/= 65 years. RESULTS: After a median 48 months follow-up [19, (10 ~ 32) ], the levels of NGAL, sdLDL-C, hemoglobin A1c (HbA1c), LDL-C, and apolipoprotein B (ApoB) were significantly higher while those of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A I (ApoA-I) were lower in MACCE positive group. NGAL correlated to body mass index (BMI) (r = 0.391, P = 0.001) and triglyceride (TG) (r = 0.228, P = 0.032), and high-sensitivity CRP (hsCRP) (r = 0.251, P = 0.007), and neutrophils (r = 0.454, P = 0.001), sdlDL-C level was found to be positively correlated with LDL-C (r = 0.413, P = 0.001), TG (r = 0.432, P = 0.001), and ApoB (r = 0.232, P = 0.002); and it was negatively correlated with HDL-C (r = -0.362, P = 0.031) and ApoA-I (r = -0.402, P = 0.001). Age-adjusted Cox regression analysis showed that NGAL (HR = 1.006, 95% confidence interval (CI): 1.005-1.008, P < 0.001) and sdLDL-C (HR = 1.052, 95% CI: 1.037-1.066, P < 0.001) were independently associated with occurrence of MACCE. ROC curve analysis showed that NGAL (area under ROC (AUC) = 0.79, 95% CI: 0.75-0.84, P < 0.001) and sdlDL-C (AUC = 0.76, 95% CI: 0.72-0.80, P < 0.001) could predict the occurrence of MACCE (area under ROC. NGAL combined with sdlDL-C could predict the occurrence of MACCE well (AUC = 0.87, 95% CI: 0.84-0.90, P < 0.001). CONCLUSION: The higher NGAL and sdLDL-C in T2DM patients aged >/= 65 years were significantly and independently associated with the risk of MACCE, and showed higher clinical values than other lipid biomarkers or other chronic inflammation, so they were expected to be the most effective predictors of MACCE assessment. CI - (c) 2022. The Author(s). FAU - Chen, Yanhong AU - Chen Y AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Fu, Yu AU - Fu Y AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Wang, Shixin AU - Wang S AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Chen, Pengsheng AU - Chen P AD - Department of Cardiology, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Pei, Yunfeng AU - Pei Y AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Zhang, Jiao AU - Zhang J AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Zhang, Rui AU - Zhang R AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Niu, Guoping AU - Niu G AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. FAU - Gu, Feng AU - Gu F AD - Department of Clinical Laboratory, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. 15852482679@126.com. FAU - Li, Xiaoli AU - Li X AD - Department of Cardiology, Xuzhou Central Hospital, No.199, Jiefang South Road, 221009, Xuzhou, Jiangsu, People's Republic of China. nashihuakai0704@sina.com. LA - eng PT - Journal Article DEP - 20221117 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Apolipoprotein A-I) RN - 0 (Apolipoproteins B) RN - 0 (Biomarkers) RN - 0 (Cholesterol, LDL) RN - 0 (Lipocalin-2) RN - 0 (Triglycerides) SB - IM MH - Humans MH - Apolipoprotein A-I MH - Apolipoproteins B MH - Biomarkers MH - Cholesterol, LDL MH - *Coronary Artery Disease/diagnosis MH - *Diabetes Mellitus, Type 2/diagnosis/epidemiology MH - Lipocalin-2 MH - Retrospective Studies MH - Triglycerides MH - Aged PMC - PMC9682485 OTO - NOTNLM OT - Biomarkers OT - Coronary artery disease OT - Neutrophil gelatinase-associated lipocalin OT - Predicting OT - Risk factors OT - Small low-density lipoprotein OT - Type 2 diabetes mellitus COIS- The authors declare that they have no competing interests. EDAT- 2022/11/19 06:00 MHDA- 2022/11/22 06:00 PMCR- 2022/11/17 CRDT- 2022/11/18 00:16 PHST- 2022/09/09 00:00 [received] PHST- 2022/10/14 00:00 [accepted] PHST- 2022/11/18 00:16 [entrez] PHST- 2022/11/19 06:00 [pubmed] PHST- 2022/11/22 06:00 [medline] PHST- 2022/11/17 00:00 [pmc-release] AID - 10.1186/s12933-022-01668-5 [pii] AID - 1668 [pii] AID - 10.1186/s12933-022-01668-5 [doi] PST - epublish SO - Cardiovasc Diabetol. 2022 Nov 17;21(1):252. doi: 10.1186/s12933-022-01668-5.