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Serum free fatty acids are associated with severe coronary artery calcification, especially in diabetes: a
Yangxun Xin1, Junfeng Zhang1, Yuqi Fan2
1Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Elevated serum free fatty acids (FFAs) are linked to severe coronary artery calcification (CAC), especially in patients with diabetes mellitus (DM). Higher FFAs independently predict CAC, with the strongest association observed in the DM group.
Area of Science:
- Cardiology
- Metabolic Syndrome
- Medical Diagnostics
Background:
- Serum free fatty acid (FFA) levels are implicated in coronary heart disease and diabetes mellitus (DM).
- Limited research has explored the association between serum FFA concentrations and coronary artery calcification (CAC).
Purpose of the Study:
- To investigate the relationship between serum FFA levels and the severity of coronary artery calcification (CAC).
- To determine if serum FFAs can predict severe CAC, particularly in patients with and without DM.
Main Methods:
- Retrospective analysis of 426 patients undergoing FFA quantification, coronary angiography, and intravascular ultrasound (IVUS).
- CAC severity assessed using IVUS-defined maximum calcific angle (arc); severe CAC (SCAC) defined as arc ≥ 180°.
- Logistic regression and ROC curve analysis used to evaluate the association between FFAs and SCAC, adjusting for confounders.
Main Results:
- Serum FFA levels were significantly higher in patients with SCAC compared to those without (6.62 ± 2.17 vs. 5.13 ± 1.73 mmol/dl).
- Serum FFAs were independently associated with SCAC in the overall cohort, non-DM, and DM groups (ORs ranging from 1.273 to 1.939).
- ROC analysis indicated predictive capacity for FFAs for SCAC (AUC 0.695 overall), with higher predictability in the DM group (AUC 0.775).
Conclusions:
- Serum FFA levels are independently associated with severe coronary artery calcification.
- Serum FFAs demonstrate predictive capability for SCAC, with the strongest association observed in patients with diabetes mellitus.
Background:
Serum free fatty acid (FFA) concentrations are associated with coronary heart disease and diabetes mellitus (DM). Few studies focused on the relationship between serum FFA levels and coronary artery calcification (CAC).
Methods:
This was a retrospective, single-centered study recruiting patients underwent FFA quantification, coronary angiography and intravascular ultrasound (IVUS). CAC severity was assessed with the maximum calcific angle (arc) of the calcified plaque scanned by IVUS. Patients with an arc ≥ 180° were classified into the severe CAC (SCAC) group, and those with an arc < 180° were classified into the non-SCAC group. Clinical characteristics, serum indices were compared between 2 groups. Logistic regression, receiver operating characteristic (ROC) curves and area under the curves (AUC) were performed.
Results:
Totally, 426 patients with coronary artery disease were consecutively included. Serum FFA levels were significantly higher in the SCAC group than non-SCAC group (6.62 ± 2.17 vs. 5.13 ± 1.73 mmol/dl, p < 0.001). Logistic regression revealed that serum FFAs were independently associated with SCAC after adjusting for confounding factors in the whole cohort (OR 1.414, CI 1.237-1.617, p < 0.001), the non-DM group (OR 1.273, CI 1.087-1.492, p = 0.003) and the DM group (OR 1.939, CI 1.388-2.710, p < 0.001). ROC analysis revealed a serum FFA AUC of 0.695 (CI 0.641-0.750, p < 0.001) in the whole population. The diagnostic predictability was augmented (AUC = 0.775, CI 0.690-0.859, p < 0.001) in the DM group and decreased (AUC = 0.649, CI 0.580-0.718, p < 0.001) in the non-DM group.
Conclusions:
Serum FFA levels were independently associated with SCAC, and could have some predictive capacity for SCAC. The association was strongest in the DM group.
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