Abstract
High-density lipoprotein (HDL) confers protection against cardiovascular disease partly attributable to its robust anti-oxidant activities, which is largely impaired in diabetic conditions. In this study, we analyzed the anti-oxidant activity of HDL, as represented by the arylesterase activity of paraoxonase 1 (PON1) in HDL particles, in 216 consecutive HF patients with (n = 79) or without (n = 137) type 2 diabetes, and age- and gender-matched 112 diabetic and 189 non-diabetic non-HF controls. We found arylesterase activity was significantly decreased in patients with than without HF, and was further decreased when comorbid with diabetes. After adjusting for conventional risk factors and apolipoprotein A-I levels, arylesterase activity remained correlated positively with left ventricular ejection fraction in diabetic (r = 0.325, P = 0.020) but not non-diabetic patients (r = 0.089, P = 0.415), and negatively with NT-proBNP and NYHA functional class in both subgroups. In regression analyses, a higher risk of HF was observed in diabetic than non-diabetic patients when having low arylesterase activities. In conclusion, our data demonstrate that impaired serum arylesterase activity in patients with HF is further reduced when comorbid with diabetes. The relationship of impaired arylesterase activity to HF is especially enhanced in diabetic patients.
Highlights
Www.nature.com/scientificreports risk of incident long-term adverse cardiac event independent of established clinical risk factors[17]
No significant differences between diabetic and non-diabetic patients with HF were observed for left atrial diameter, left ventricular end-diastolic or end-systolic volumes, left ventricular ejection faction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and medication of ACEI/ARB, β-adrenergic receptor blockers, diuretics, statins, and antiplatelet agents
The major findings of the present study are that impaired serum arylesterase activity in patients with HF is further reduced when comorbid with diabetes
Summary
Www.nature.com/scientificreports risk of incident long-term adverse cardiac event independent of established clinical risk factors[17]. The functional activity of HDL is largely impaired, which may further aggravate the imbalance between pro-oxidant and anti-oxidant substrates within the failing myocardium. We showed that decreased paraoxonase activity was associated with the presence and severity of coronary artery disease in patients with type 2 diabetes mellitus (T2DM)[18]. We analyzed the relationship of seurm arylesterase activity to systolic heart failure in T2DM patients and non-diabetic subjects
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