Introduction
Method and materials
Study design and participants
Preparation of blood samples
Demographic, clinical and laboratory assessments
Ceramide measurements
Cytokine measurements
Statistical analyses
Results
Demographic, clinical and laboratory findings
Clinical characteristics | total(n = 216) | ACS (n = 138) | non ACS (n = 78) | P |
---|---|---|---|---|
DM(n,%) | 66 (30.6) | 51 (37.0) | 15 (19.2) | 0.007 |
Age | 60.61 | 59.88 | 61.90 | 0.170 |
Gender | 131 (60.6) | 96 (69.6) | 35 (44.9) | 0.000 |
Hypertention(n,%) | 130 (60.2) | 85 (61.2) | 45 (57.7) | 0.574 |
Current smoker(n,%) | 74 (34.3) | 61 (44.2) | 13 (16.7) | 0.000 |
Alcohol status(n,%) | 40 (18.5) | 31 (22.5) | 9 (11.5) | 0.047 |
Presentation of ACS | ||||
STEMI(n,%) | 11 (5.09) | 11 (7.97) | ||
NSTEMI(n,%) | 25 (11.57) | 25 (18.12) | ||
UAP(n,%) | 102 (47.22) | 102 (73.91) | ||
BMI(kg/cm2) | 26.59 ± 4.27 | 26.08 ± 3.80 | 27.51 ± 4.89 | 0.018 |
TG(mmol/L) | 1.74 ± 0.98 | 1.84 ± 1.11 | 1.56 ± 0.69 | 0.020 |
TC(mmol/L) | 4.21 ± 1.27 | 4.33 ± 1.15 | 3.99 ± 1.43 | 0.063 |
HDL-C(mmol/L) | 1.16 ± 0.28 | 1.12 ± 0.26 | 1.23 ± 0.29 | 0.004 |
LDL-C(mmol/L) | 2.41 ± 0.94 | 2.37 ± 0.98 | 2.47 ± 0.87 | 0.475 |
LPa(mmol/L) | 62.48 ± 84.89 | 70.69 ± 98.11 | 47.97 ± 51.49 | 0.027 |
FBG(mmol/L) | 6.66 ± 2.73 | 6.91 ± 3.01 | 6.23 ± 2.10 | 0.053 |
BNP(pg/mL) | 84.62 ± 144.59 | 98.19 ± 163.72 | 60.63 ± 98.84 | 0.037 |
hs-CRP(mg/L) | 3.00 ± 4.34 | 2.92 ± 3.77 | 3.13 ± 5.22 | 0.730 |
Pro-inflammatory cytokine plasma levels and ceramides of participants
Variables | total(n = 216) | ACS(n = 138) | non ACS(n = 78) | P |
---|---|---|---|---|
TNF-α(pg/mL) | 11.75 ± 8.78 | 13.04 ± 9.21 | 9.47 ± 7.47 | 0.004 |
IL-6(pg/mL) | 7.59 ± 5.36 | 9.09 ± 5.70 | 5.93 ± 3.99 | 0.000 |
IL-8(pg/mL) | 24.08 ± 14.14 | 24.45 ± 13.65 | 23.41 ± 15.04 | 0.604 |
Cer (d18:1/16:0)(µmol/L) | 155.17 ± 48.11 | 165.00 ± 49.09 | 137.79 ± 41.20 | 0.000 |
Cer (d18:1/18:0)(µmol/L) | 44.75 ± 18.85 | 46.71 ± 18.81 | 41.28 ± 18.54 | 0.042 |
Cer (d18:1/24:0)(µmol/L) | 1835.10 ± 6761.38 | 1933.30 ± 710.43 | 1661.36 ± 559.21 | 0.004 |
Cer (d18:1/24:1)(µmol/L) | 486.19 ± 193.99 | 495.28 ± 180.50 | 470.10 ± 216.09 | 0.361 |
Cer (d18:1/14:0)(µmol/L) | 2.68 ± 1.36 | 2.80 ± 1.43 | 2.48 ± 1.21 | 0.097 |
Cer (d18:1/20:0)(µmol/L) | 54.10 ± 20.53 | 56.27 ± 21.37 | 50.25 ± 18.45 | 0.038 |
Cer (d18:1/22:0)(µmol/L) | 421.32 ± 159.87 | 442.57 ± 174.76 | 383.72 ± 121.56 | 0.009 |
The association between ceramide and inflammatory factors
TNF-α | IL6 | IL8 | hs-CRP | |||||
---|---|---|---|---|---|---|---|---|
r | P | r | P | r | P | r | P | |
Cer (d18:1/16:0) | -0.081 | 0.236 | 0.027 | 0.696 | -0.030 | 0.664 | 0.127 | 0.063 |
Cer (d18:1/18:0) | -0.035 | 0.606 | -0.043 | 0.533 | -0.098 | 0.152 | 0.138 | 0.043 |
Cer (d18:1/24:0) | -0.124 | 0.069 | -0.041 | 0.544 | -0.046 | 0.497 | 0.099 | 0.148 |
Cer (d18:1/24:1) | -0.070 | 0.308 | -0.084 | 0.220 | -0.066 | 0.332 | 0.040 | 0.186 |
Cer (d18:1/14:0) | -0.131 | 0.055 | -0.077 | 0.258 | -0.019 | 0.786 | 0.087 | 0.205 |
Cer (d18:1/20:0) | -0.094 | 0.171 | -0.130 | 0.057 | -0.085 | 0.216 | 0.139 | 0.042 |
Cer (d18:1/22:0) | -0.136 | 0.045 | -0.099 | 0.149 | -0.050 | 0.465 | 0.127 | 0.063 |
Univariable and multivariable logistic regression results: the clinical acute coronary syndrome predictors
Variables | Univariate | P value | Multivariate | P value |
---|---|---|---|---|
OR(95%CI) | OR(95%CI) | |||
Age | 0.981 (1.580–4.990) | 0.000 | ||
Male | 2.808 (1.272–4.767) | 0.000 | 2.702 (1.290–5.658) | 0.008 |
DM | 2.462 (1.272–4.767) | 0.008 | 2.329 (1.077–5.035) | 0.032 |
Hypertention | 1.176 (0.668–2.070) | 0.574 | ||
Current smoker | 3.961 (1.999–7.848) | 0.000 | 2.702 (1.204–6.066) | 0.016 |
Alcohol | 2.221 (0.997–4.951) | 0.051 | ||
BMI | 0.922 (0.862–0.987) | 0.02 | ||
TG | 1.405 (1.008–1.960) | 0.045 | ||
TC | 1.240 (0.987–1.557) | 0.065 | ||
HDL-c | 0.227 (0.081–0.636) | 0.005 | ||
LDL-c | 0.898 (0.669–1.205) | 0.474 | ||
LPa | 1.004 (1.000-1.008) | 0.065 | 1.006 (1.000-1.012) | 0.04 |
FBG | 1.108 (0.986–1.245) | 0.084 | ||
BNP | 1.002 (1.000-1.005) | 0.083 | ||
hs-CRP | 0.989 (0.928–1.053) | 0.729 | ||
TNF-α | 1.063 (1.018–1.109) | 0.005 | ||
IL-6 | 1.157 (1.077–1.243) | 0.000 | 1.173 (1.082–1.271) | 0.000 |
IL-8 | 1.005 (0.985–1.026) | 0.603 | ||
Cer(d18:1/16:0) | 1.016 (1.008–1.024) | 0.000 | 1.018 (1.008–1.028) | 0.000 |
Cer(d18:1/18:0) | 1.017 (1.000-1.034) | 0.045 | ||
Cer(d18:1/24:0) | 1.001 (1.000-1.001) | 0.005 | ||
Cer(d18:1/24:1) | 1.001 (0.999–1.002) | 0.362 | ||
Cer(d18:1/14:0) | 1.205 (0.965–1.505) | 0.100 | ||
Cer (d18:1/20:0) | 1.016 (1.001–1.032) | 0.041 | ||
Cer (d18:1/22:0) | 1.003 (1.001–1.005) | 0.011 |
Predictive value of the models for acute coronary syndrome
Old model | New model | AUC(95%CI) | P value -AUC |
---|---|---|---|
Model 1 | - | 0.722 (0.653-0.791) | |
Model 1 | model 2 | 0.785 (0.723-0.846) | 0.01 |
Model 1 | model 3 | 0.782 (0.720-0.845) | 0.015 |
Model 1 | model 4 | 0.827 (0.770-0.884) | 0.001 |