Inflammation mediated glycolipid dysregulation in coronary microvascular disease pathogenesis

Coronary microvascular disease (CMVD) is associated with abnormalities in glucose-lipid metabolism. And the triglyceride to high density lipoprotein (HDL) (TG/HDL) ratio can be used to characterize levels of glycolipid metabolism. Therefore, it is hypothesized that increased TG/HDL may trigger CMVD. This study enrolled patients with angina pectoris but negative coronary angiograms to explore inflammatory factor-mediated disorder of glycolipid metabolism triggers CMVD. Logistics regression model and subgroup analysis were constructed to explore the associations between TG/HDL and CMVD. Restricted cubic splines were applied to further the associations of TG/HDL with CMVD. Given inflammatory factors as intermediary factor, we investigate the mediating effects of TG/HDL on CMVD. 242 patients were eventually recruited and 150 patients were diagnosed with CMVD. In the multivariable-adjusted model, TG/HDL and inflammatory indexes including the C-reaction protein (CRP), C-reaction protein to lymphocyte ratio (CLR) and inflammatory burden index (IBI) were positively related to CMVD (Odds Ratio (OR) = 1.71, 95% CI = 0.69-4.25; OR = 1.89, 95% CI = 1.32-2.68; OR = 2.76, 95% CI = 1.56-4.89; OR = 1.22, 95% CI = 1.08-1.37, respectively). Mediation analysis indicated that CRP, CLR and IBI mediated 26.37%, 16.89% and 10.45% of the association of TG/HDL with CMVD. TG/HDL is positively associated with CMVD. And this association appeared to be partially mediated through inflammatory indices.