fa مقایسه سطح و عملکرد لیپوپروتئین با چگالی بالا (HDL) برای تشخیص بیماری عروق کرونر فیزیولوژی Physiology مقاله پژوهشی Research Article <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">سابقه</span></span></b><b> </b><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">و</span></span></b><b> </b><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">هدف:</span></span></b> <span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">لیپوپروتئین با چگالی بالا</span></span> <span dir="LTR" new="" roman="" style="font-family:" times="">(HDL)</span><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> به عنوان یک عامل محافظ در برابر بیماری عروق کرونر</span></span> <span b="" lang="FA" nazanin="" style="font-family:">(</span><span dir="LTR" new="" roman="" style="font-family:" times="">CAD</span><span b="" lang="FA" nazanin="" style="font-family:">) </span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">شناخته شده</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">است.</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">در</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">مطالعات اخیر، بررسی عملکرد </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">HDL</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> بیشتر از اندازه&shy;گیری سطح آن مورد توجه محققان قرار گرفته است.</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> بنابراین هدف از مطالعه حاضر، مقایسه سطح و عملکرد</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">HDL</span> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">&nbsp;برای تشخیص</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">CAD</span> &nbsp;<span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">بود. </span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">مواد و روش&shy; ها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> این مطالعه (مورد- شاهدی) بر روی 853 نفر شامل 572 بیمار مبتلا به </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">CAD</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> و 281 فرد سالم انجام گرفت. پروفایل لیپیدی و </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times="">hs-CRP</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> به ترتیب با روش&shy;های آنزیمی و ایمونوتوربیدومتری اندازه&shy;گیری شدند.</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> <span style="letter-spacing:-.2pt">عملکرد </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">HDL</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> از طریق اندازه گیری فعالیت آنزیم پاراکسوناز 1 </span></span></span><span lang="FA" new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">(</span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">PON1</span></span><span lang="FA" new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.2pt">)</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> و اثر آن بر سوبسترای پاراکسون با استفاده از روش اسپکتروفتومتری مورد بررسی قرار گرفت. از آنالیز منحنی راک برای مقایسه قدرت تشخیص فاکتورهای مورد مطالعه استفاده گردید. </span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">آنالیز رگرسیون لجستیک </span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">چندگانه </span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">برای شناسایی ریسک فاکتورهایی که ارتباط مستقل با </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">CAD</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> دارند به کار برده شد.</span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">یافته &shy;ها:</span></span></b> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">در بیماران مبتلا به </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">CAD</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> نسبت به افراد سالم، </span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">کاهش </span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">معنی داری در سطح و عملکرد </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">HDL</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> مشاهده گردید (001/0</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">p<</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">). </span></span><span lang="AR-SA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">براساس آنالیز منحنی راک، سطح زیر منحنی </span></span><span lang="AR-SA" new="" roman="" style="font-family:" times="">(</span><span dir="LTR" new="" roman="" style="font-family:" times="">AUC</span><span lang="AR-SA" new="" roman="" style="font-family:" times="">)</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> برای فعالیت آنزیم </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">PON1</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> در مقایسه با </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">HDL-C</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> بیشتر بود. نتایج آنالیز رگرسیون لجستیک چندگانه نشان داد که دیابت، فشارخون بالا، مصرف سیگار، </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">hs-CRP</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> و فعالیت آنزیم </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">PON1</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> به عنوان ریسک فاکتورهای مستقل در ابتلا به </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">CAD</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> می</span></span><span dir="LTR" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">&shy;</span></span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">باشند. </span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">نتیجه &shy;گیری:</span></span></b> <span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:">ارزیابی عملکرد </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">HDL</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> در مقایسه با اندازه&shy;گیری سطح آن، معیار مناسب تری جهت تشخیص </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">CAD</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> می&shy;باشد. فعالیت آنزیم </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">PON1</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> به عنوان یک بیومارکر تشخیصی برای </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">CAD</span><span lang="FA" style="font-size:12.0pt"><span b="" nazanin="" style="font-family:"> پیشنهاد می&shy;شود.</span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br> <br> &nbsp; <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#242021">Aim and</span></span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> <b><span style="color:#242021">Background: </span></b></span></span><span new="" roman="" style="font-family:" times="">High-density lipoprotein (HDL) is known to be a protective factor against coronary artery disease (CAD). In recent studies, investigating the function of HDL more than measuring its level has attracted the attention of researchers. </span><span lang="EN" new="" roman="" style="font-family:" times="">Therefore, the </span><span new="" roman="" style="font-family:" times="">aim of </span><span lang="EN" new="" roman="" style="font-family:" times="">present study was to compare the level and function of HDL for the diagnosis of CAD.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span lang="EN" style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"></span></span></b></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#242021">Materials and Methods: </span></span></span></b><span lang="EN" new="" roman="" style="font-family:" times="">This study (case-control) was conducted on 853 people, including 572 patients with CAD and 281 healthy</span><span new="" roman="" style="font-family:" times=""> subjects. </span><span lang="EN" new="" roman="" style="font-family:" times="">Lipid profile and hs-CRP were measured by enzymatic and immunoturbidometric methods, respectively.</span> <span lang="EN" new="" roman="" style="font-family:" times="">HDL function was evaluated by measuring the activity of the paraoxonase 1 (PON1) enzyme and its effect on paraoxon substrate using the spectrophotometric method.</span> <span lang="EN" new="" roman="" style="font-family:" times="">ROC curve analysis was used to compare the detection power of the studied factors.</span> <span lang="EN" new="" roman="" style="font-family:" times="">Multivariate logistic regression analysis was used to identify risk factors that have an independent </span><span new="" roman="" style="font-family:" times="">relationship</span><span lang="EN" new="" roman="" style="font-family:" times=""> with CAD.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span lang="EN" style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"></span></span></b></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#242021">Results</span></span></span></b><b><span new="" roman="" style="font-family:" times=""><span style="color:#242021">: </span></span></b><span lang="EN" new="" roman="" style="font-family:" times="">A significant decrease in the level and function of HDL was observed in patients with CAD than in healthy individuals (p<0.001). Based on ROC curve analysis, the area under the curve (AUC) for PON1 enzyme activity was higher than HDL-C. </span><span new="" roman="" style="font-family:" times=""><span style="color:#242021">The</span></span><span lang="EN" new="" roman="" style="font-family:" times=""> results of</span><b> </b><span lang="EN" new="" roman="" style="font-family:" times="">multivariable logistic regression analysis showed that diabetes, </span><span new="" roman="" style="font-family:" times=""><span style="color:black">hypertension,</span></span> <span lang="EN" new="" roman="" style="font-family:" times="">smoking, hs-CRP, and PON1 enzyme activity are independent risk factors for CAD.</span><b><span lang="EN" style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"></span></span></b></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span lang="EN" style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"></span></span></b></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#242021">Conclusion</span></span></span></b><b><span new="" roman="" style="font-family:" times=""><span style="color:#242021">: </span></span></b><span lang="EN" new="" roman="" style="font-family:" times="">Evaluation of HDL function is a more appropriate criterion for diagnosing CAD than measuring its level. PON1 enzyme activity is suggested as a diagnostic biomarker for CAD.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:309.75pt"><span style="font-family:Calibri,sans-serif"><b><span lang="EN" style="font-family:"Times New Roman",serif"></span></b></span></span></span></span><br> &nbsp; لیپوپروتئین با چگالی بالا, بیماری عروق کرونر, آنزیم پاراکسوناز 1, Iau Science. high density lipoprotein, coronary artery disease, paraoxonase 1 enzyme, Iau Science. 31 40 http://ncmbjpiau.ir/browse.php?a_code=A-10-1986-2&slc_lang=fa&sid=1 Shima Yazdandoust شیما یزدان دوست 100319475328460014746 100319475328460014746 No Seyyed Mohammad Reza Parizadeh سید محمدرضا پریزاده 100319475328460014747 100319475328460014747 No Majid Ghayour-Mobarhan مجید غیور مبرهن ghayourm@mums.ac.ir 100319475328460014748 100319475328460014748 Yes NESCO International Center for Basic Medical Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran مرکز بین المللی یونسکو علوم پایه پزشکی و تغذیه انسانی، دانشگاه علوم پزشکی مشهد، مشهد، ایران Parichehreh Yaghmaei پریچهر یغمائی 100319475328460014749 100319475328460014749 No Amir Hossein Sahebkar امیرحسین صاحبکار 100319475328460014750 100319475328460014750 No