fa مقایسه نسبتهای آتروژنیک با استفاده از پاراکسوناز 1 و HDL-C برای تشخیص شدت بیماری عروق کرونر در بیماران مبتلا به دیابت نوع 2 با نفروپاتی بیوشیمی Sports biomechanics گزارش کوتاه Brief Report <span style="font-size:12pt"><span style="tab-stops:344.4pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" style="font-family:" zar="">&nbsp;</span></b></span></span></span></span><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">براساس مطالعات جدید، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">HDL-C</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> بیومارکر مناسبی برای تشخیص بیماری‌های قلبی عروقی نیست. مطالعه حاضر جهت بررسی جایگزین کردن فعالیت آنزیم پاراکسوناز 1 (</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">PON1</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">) به‌جای </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">HDL-C</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> جهت افزایش قدرت تشخیص بیماری عروق کرونر (</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CAD</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">) در بیماران مبتلا به دیابت نوع 2 (</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">T2D</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">) با نفروپاتی، طراحی شد.<span style="color:#0e101a"></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">مطالعه مقطعی حاضر بر روی 48 بیمار </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">T2D</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> که تحت آنژیوگرافی قرار گرفتند، انجام شد. بیماران براساس نتایج آنژیوگرافی به دو گروه </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CAD</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">non-CAD</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> تقسیم شدند. فعالیت آنزیم </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">PON1</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> با اندازه‌گیری سرعت اولیه هیدرولیز سوبسترا (فنیل استات) از طریق روش اسپکتروفتومتری در طول موج 270 نانومتر&nbsp; سنجش شد. برای مطالعه قدرت تشخیص بیومارکرهای مورد مطالعه از آزمون </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">ROC (</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">Receiver operating characteristic</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">)</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> استفاده شد.<span style="color:black"></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">نتایج آزمون </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">ROC</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> نشان داد که قدرت تشخیصی بیومارکرهای مورد مطالعه با جایگزین کردن </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">PON1</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> به‌جای </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">HDL-C</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> افزایش پیدا می‌کند. </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">LDL-C/PON1</span></span><span style="line-height:90%"><span b="" style="font-family:" zar=""> <span lang="FA" style="letter-spacing:-.2pt">(0/048</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">P=</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">، 0/72</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">AUC=</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">) و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">log (TG/PON1)</span></span><span style="line-height:90%"><span b="" style="font-family:" zar=""> <span lang="FA" style="letter-spacing:-.2pt">(0/005</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">P=</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">، 0/81</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">AUC=</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">) در مقایسه با </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">LDL-C/HDL-C</span></span><span style="line-height:90%"><span b="" style="font-family:" zar=""> <span lang="FA" style="letter-spacing:-.2pt">(0/276</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">P=</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">، 0/56</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">AUC=</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">) و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">log (TG/HDL-C)</span></span><span style="line-height:90%"><span b="" style="font-family:" zar=""> <span lang="FA" style="letter-spacing:-.2pt">(0/038</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">P=</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">، 0/67</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">AUC=</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">) &nbsp;در تشخیص ریسک </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CAD</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> قدرت پیش‌بینی‌کنندگی بالاتری داشتند.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">نسبتهای </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">LDL-C/PON1</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">log (TG/PON1)</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> در مقایسه با </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">LDL-C/HDL-C</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">log (TG/HDL-C)</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> قدرت پیش‌بینی </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CAD</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> را در بیماران </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">T2D</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> با نفروپاتی افزایش می‌دهند. یافته‌های مطالعه حاضر از تلاش‌ها برای استفاده از عملکرد </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">HDL</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> بجای غلظت‌های </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">HDL-C</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> برای تشخیص </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CAD</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> حمایت می‌کنند.</span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%">&nbsp;</span></span></b></span><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Background and purpose:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="letter-spacing:-.2pt">Recent studies suggest that HDL-C may not serve as a useful biomarker in the diagnosis of coronary artery disease (CAD). The present study aimed to improve the </span></span></span><span style="font-size:10.0pt"><span style="line-height:150%">prediction of CAD in type 2 diabetes (T2D) patients with nephropathy by substituting the activity of paraoxonase 1 (PON1) for HDL-C.&nbsp;&nbsp; </span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Materials and methods:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"> This study examined 48 T2D patients who underwent coronary angiographic examination. The subjects were divided into two groups: non-CAD and CAD. For measuring PON1 activity, the initial rate of substrate hydrolysis (phenylacetate) was spectrophotometrically assayed at 270 nm. Receiver operating characteristic (ROC) analyses were performed to compare the predictive performance of the study biomarkers. </span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Results:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"> The area under the ROC curve showed increases in the diagnostic performance of the study atherogenic ratios by replacing HDL-C with the PON1 in T2D patients with nephropathy. LDL-C/PON1 (AUC=0.72, P=0.048) and log (TG/PON1) (AUC=0.81, P=0.005) had higher predictive powers compared with LDL-C/HDL-C (AUC=0.56, P=0.276) and log (TG/HDL-C) (AUC=0.67, p=0.038) for CAD risk assessment.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"> The ratios of LDL-C/PON1 and log (TG/PON1) improve the prediction of CAD in T2D patients with nephropathy.<b> </b>Our findings support efforts to practically use HDL function instead of HDL-C levels for CAD diagnosis.</span></span></span></span></span><br> &nbsp; دیابت نوع 2, بیماری عروق کرونر, پاراکسوناز 1, HDL-C, بیومارکرها type 2 diabetes, coronary artery disease, PON1, HDL-C, biomarkers 132 138 http://jmums.mazums.ac.ir/browse.php?a_code=A-10-16358-1&slc_lang=fa&sid=1 Abdolkarim Mahrooz عبدالکریم مهروز amahrooz@mazums.ac.ir 1003194753284600155108 1003194753284600155108 Yes Associate Professor, Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran دانشیار، گروه بیوشیمی بالینی و ژنتیک پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران Omeh Farveh Khosravi-Asrami امه فروه خسروی-اسرمی s.alegh1980@gmail.com 1003194753284600155109 1003194753284600155109 No MSc in Clinical Biochemistry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran کارشناسی ارشد بیوشیمی بالینی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران Ahad Alizadeh احد علیزاده st.alizadeh@gmail.com 1003194753284600155110 1003194753284600155110 No Assistant Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran استادیار، گروه اپیدمیولوژی و آمار، دانشکده پزشکی، دانشگاه علوم پزشکی قزوین، قزوین، ایران Mani Nosrati مانی نصرتی mani.nosrati677@gmail.com 1003194753284600155111 1003194753284600155111 No MSc in Clinical Biochemistry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran کارشناسی ارشد بیوشیمی بالینی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران