[Biochemical markers for detection of atherosclerotic vascular complications]

Atherosclerotic vascular complication is considered as a final complication of lifestyle-related disease; however, suitable biochemical markers to detect vascular complications are yet to be determined. To clarify the clinical usefulness of oxidized low-density lipoprotein(oxLDL), high-sensitive C-reactive protein (hsCRP), and serum lysophosphatidylcholine (LPC) for the detection of vascular complications in type 2 diabetics, we evaluated the clinical implications of oxLDL, hsCRP and LPC in relation to clinical backgrounds and vascular complications. OxLDL was measured by ELISA(Mercodia, Sweden), hsCRP by immunonephelometry (Roche Diagnostics, Germany) and LPC by enzymatic methods (Alfresa, Japan), respectively. The oxLDL level did not differentiate any vascular complications; however, hsCRP was significantly higher in patients with ischemic heart disease (IHD), and LPC was significantly lower in patients with IHD and macroangiopathy composed of IHD, cerebral vascular accident and arteriosclerosis obliterans. Interestingly, the plasma LPC level was lower in women than in men. Multivariate regression analysis revealed that IHD potently contributed negatively to the LPC level, and also contributed positively to the hsCRP level, but did not contribute to the oxLDL level. Multivariate regression analysis also revealed that LPC, but not oxLDL nor hsCRP, contributed to the development of IHD and macroangiopathy. Thus, LPC is a better biochemical marker than oxLDL and hsCRP for the detection of vascular complications.