Circulating malondialdehyde-modified LDL-related variables and coronary artery stenosis in asymptomatic patients with type 2 diabetes

Abstract

Aims: To elucidate the levels of malondialdehyde-modified LDL (MDA-LDL)-related variables for predicting coronary artery stenosis (CAS) by coronary CT angiography (CCTA) in asymptomatic patients with type 2 diabetes (T2DM).

Methods: Enrolled were 36 Japanese patients with T2DM who underwent CCTA and in whom MDA-LDL levels were measured. Definition of CAS was luminal narrowing of ≥50%. Trends through tertiles of each MDA-LDL-related variable were analyzed with a general linear model. The ability of each MDA-LDL-related variable to predict CAS was compared to areas under the curve (AUCs) in receiver operating characteristic curve (ROC) analysis.

Results: Seventeen patients had CAS. Each MDA-LDL-related variable was an independent predictor of CAS (P = 0.039 for MDALDL, P = 0.013 for MDA-LDL/LDL-C, P = 0.047 for MDA-LDL/HDL-C, and P = 0.013 for (MDA-LDL/LDL-C)/HDL-C). AUCs of MDA-LDL, MDA-LDL/LDL-C, MDA-LDL/HDL-C, and (MDA-LDL/LDL-C)/HDL-C were 0.675 (95% CI 0.496-0.854), 0.765 (0.602-0.927), 0.752 (0.592-0.913), and 0.799 (0.643-0.955), respectively, for predicting CAS. Trends throughout the tertiles showed significant associations between MDA-LDL/LDL-C, MDA-LDL/HDL-C, or (MDALDL/LDL-C)/HDL-C and CAS (P = 0.003 for MDA-LDL/LDL-C, P = 0.042 for MDA-LDL/HDL-C, and P = 0.001 for (MDA-LDL/LDL-C)/HDL-C).

Conclusions: Data suggest that measurements of MDA-LDL/LDL-C, MDA-LDL/HDLC, and (MDA-LDL/LDL-C)/HDL-C are useful for predicting CAS.

Figure 1

Percentage of subjects with coronary artery stenosis in tertiles (T) of (a) MDA-LDL, (b) MDA-LDL/LDL-C, (c) MDA-LDL/HDL-C, and (d) (MDA-LDL/LDL-C)/HDL-C. There was a significant association between MDA-LDL/LDL-C, MDA-LDL/HDL-C or (MDA-LDL/LDL-C)/HDL-C and the presence of coronary artery stenosis (P = 0.003 for MDA-LDL/LDL-C, P = 0.042 for MDA-LDL/HDL-C, P = 0.001 for (MDA-LDL/LDL-C)/HDL-C). MDA-LDL, malondialdehyde-modified LDL; MDA-LDL/LDL-C, MDA-LDL-to-LDL cholesterol ratio; MDA-LDL-C/HDL-C, MDA-LDL-to-HDL cholesterol ratio. ^∗ P < 0.05versuss T1 and ^∗∗ P < 0.01.

Figure 2

Comparison among the AUCs of MDA-LDL, MDA-LDL/LDL-C, MDA-LDL/HDL-C, and (MDA-LDL/LDL-C)/HDL-C for the presence of coronary artery stenosis. The AUCs (95% confidence interval) were as follows: MDA-LDL 0.675 (0.496–0.854), MDA-LDL/LDL-C 0.765 (0.602–0.927), MDA-LDL/HDL-C 0.752 (0.592–0.913), and (MDA-LDL/LDL-C)/HDL-C 0.799 (0.643–0.955). MDA-LDL: malondialdehyde-modified LDL; MDA-LDL/LDL-C: MDA-LDL-to-LDL cholesterol ratio; MDA-LDL-C/HDL-C: MDA-LDL-to-HDL cholesterol ratio; (MDA-LDL/LDL-C)/HDL-C: (MDA-LDL/LDL-C) to the HDL cholesterol ratio.