Clinical Demography Characteristics, Routine and Advanced Lipid Indexes
300 patients were enrolled in this study, among which, 242 patients were diagnosed with CHD and assigned to CHD Group, 123 patients were diagnosed with DM and 75 patients were diagnosed with MS, assigned to DM Group and MS Group. As the Supplement Table 1 ~ 3 showed, 9 clinical information and 139 NMR results were compared between CHD Group and non-CHD Group, DM Group and non-DM Group, MS Group and non-MS Group.
As shown in Supplement Table 1, age, both the triglycerides of LDL and LDL-6 were higher in CHD group, while the ethanol was lower in the comparison with non-CHD group. In the comparison between DM and non-DM patients, shown in Supplement Table 2, there was little variables with significant differences. Most of the differences of clinical characteristics and NMR measured lipid indexes were statistically significant in the comparison between MS group and non-MS group (Supplement Table 3). In the clinical characteristics comparison, age, fasting plasma glucose (FPG), the rate of smoking, overweight, diabetes, hypertension and CHD family history were significantly higher in MS group, but the PCSK9 was much lower in MS patients, which was inconsistent with our cognition. Total cholesterol (TC), TG and apolipoprotein B (apoB) were higher in MS group, while HDL-C and apolipoprotein A2 (apoA2) were lower. Total lipoprotein particles, as well as the particles of VLDL, IDL, LDL were more in MS group and the higher LDL particle in MS group was mainly due to LDL-5 and LDL-6. Almost all TG, CE, FC and PL of VLDL and IDL were much higher in MS group, while the advantage of those contents of LDL in MS patients was mostly concentrated in LDL-3, LDL-4 and LDL-6. And even the TG of HDL were much higher in MS patients, while CE, FC and PL of HDL were higher in non-MS patients. In addition, higher glutamine in MS group was the only differentiated metabolites found in the comparison with non-MS patients.
Risk Factors of CHD
As Figure 2 showed the result of multiple Logistic regression, age (odds ratio (OR) = 2.520, 95% confidence interval (CI): 1.081 ~ 5.086, P = 0.032), the particle of LDL-6 (OR = 1.006, 95% CI: 1.001 ~ 1.012, P = 0.022), LDL-6-TG (OR = 1.200, 95% CI: 1.034 ~ 1.393, P = 0.016) and LDL-6-FC (OR = 1.330, 95% CI: 1.142 ~ 1.549, P < 0.001) were risk factors of CHD. While, glycerol (OR = 0.167, 95% CI: 0.032 ~ 0.868, P = 0.041) were the protective factors of CHD.
The Relation between Gensini Score and NMR Results
Heatmaps, Figure 3 and 4, showed the direction and intensity of the Spearman correlation between Gensini score and NMR results as well as PCSK9 and NMR results, in all postmenopausal women and the patients diagnosed with CHD, DM, and MS.
In general, Figure 3 showed that the positive correlation between Gensini score and NMR results deposited in VLDL-2 ~ VLDL-5, IDL, LDL-1 and LDL-2, while the negative correlations concentrated on ApoA1, ApoA2 and HDL-1 ~ HDL-4.
In all postmenopausal women enrolled in this study, the indexes with positive correlation with Gensini score including ApoB/A1, particles of VLDL and IDL, lipoprotein contents TG in VLDL-3 ~ VLDL-5, LDL-1 ~ LDL-2, LDL-5 ~ LDL-6, CE in VLDL-2 ~ VLDL4, IDL, FC in VLDL-2 ~ VLDL-4, IDL and LDL-1 and PH in VLDL-3 ~ VLDL-5, while the indexes with negative correlation were ApoA1, ApoA2, ApoA1, CE and PL in HDL-2 ~ HDL-4, FC in HDL-3 and ApoA2 in HDL-4. The NMR results of CHD and DM patients showed a similar but not identical trends with All patients. In the MS patients, the indexes positively related to Gensini score were confined only to the TG, CE and PL in VLDL-3 ~ VLDL-5, while the negative correlated indexes were ApoA1, FC and PL in LDL-1, and ApoA1, CE, PL in HDL-1. The PCSK9 was negatively correlated with Gensini score in all patients and DM patients.
The Relation between PCSK9 and NMR Results
Figure 4 showed correlations between plasma PCSK9 and NMR results. In all patients and CHD, DM subgroups, PCSK9 showed a similar trend that negatively correlated with total cholesterol (TC), ApoB/A1, the particles of VLDL, IDL and LDL, as well as nearly all the lipid contents in VLDL-3 ~ VLDL-5, IDL and LDL-1. In MS group, there was little correlation between PCSK9 and NMR results.