Case Control Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2022; 10(7): 2095-2105
Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2095
Correlation between betatrophin/angiogenin-likeprotein3/lipoprotein lipase pathway and severity of coronary artery disease in Kazakh patients with coronary heart disease
Lian Qin, Rena Rehemuding, Aikeliyaer Ainiwaer, Xiang Ma
Lian Qin, Rena Rehemuding, Aikeliyaer Ainiwaer, Xiang Ma, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University , Urumqi 830054, Xinjiang Uygur Autonomous region, China
Author contributions: Qin L interpreted the data and drafted the manuscript; Ma X designed the study and corrected the manuscript; Ainiwaer A participated to the collection of the human material; Rehemuding R served as scientific advisor and participate to the collection of human material; Qin L and Ainiwaer A completed the experiment of this study; Ma X had full access to the data and take responsibility for the integrity of the data and the accuracy of the data analysis.
Supported by National Natural Science Foundation of China, No. 8660085; and Natural Science Foundation of Shihezi University, No. ZZZC201712A.
Institutional review board statement: This study was reviewed by the ethics committee of The First Affiliated Hospital of Shihezi University School of Medicine (Approval number: 2017-116-01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: The technical appendices and experimental data sets related to this study available from the corresponding author at maxiangxj@yeah. net.
STROBE statement: The authors have read the STROBE statement-checklist of items, and the manuscript was prepared and revised according to the STROBE statement- checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang Ma, MD, PhD, Chief Doctor, Professor, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, No. 137 Liyushan South Road, Urumqi 830054, Xinjiang Uygur Autonomous region, China. maxiangxj@yeah.net
Received: August 28, 2021
Peer-review started: August 28, 2021
First decision: November 17, 2021
Revised: December 1, 2021
Accepted: January 22, 2022
Article in press: January 22, 2022
Published online: March 6, 2022
ARTICLE HIGHLIGHTS
Research background

Lipid metabolism plays an essential role in the pathogenesis of atherosclerosis, a major cause for coronary heart disease (CHD). Lipid regulation therapy can reduce major adverse cardiovascular events. Although previous studies have shown that betatrophin, angiogenin-like protein 3 and lipoprotein lipase are jointly involved in lipid regulation, the interaction and mechanism of action between them are still controversial.

Research motivation

The purpose of this study was to explore the correlation between the betatrophin/ angiogenin-likeprotein3 (ANGPTL3) / lipoprotein lipase (LPL) pathway and severity of coronary artery disease in patients with CHD. The detection of this pathway in CHD patients with acute coronary occlusion may have more diagnostic value. Betatrophin can also be used as a target for new lipid regulation treatments to provide clues for the development of new drugs.

Research objectives

The betatrophin/ANGPTL3/LPL pathway is related to the severity of CHD. In addition, the results showed that the levels of LPL and ANGPTL3 in CHD patients increased, and their increasing trends were consistent. The detection of this pathway can be used as one of the non-invasive tools to evaluate the severity of coronary artery disease (CAD) lesions in patients with CHD. Not only that, betatrophin may also serve as a new target for lipid regulation therapy.

Research methods

This case–control study involved 277 individuals. Nondiabetic patients diagnosed with CHD were selected as the case group; 79 were of Kazakh descent and 72 were of Han descent. The control groups comprised of 61 Kazakh and 65 Han individuals. The serum levels of betatrophin and LPL were detected by enzyme-linked immunosorbent assay (ELISA), and the double antibody sandwich ELISA was used to detect serum level of ANGPTL3. The data are expressed as average ± standard deviation, and the statistical differences between the data were compared by independent sample t-test. Differences between groups were analyzed by two-way analysis of variance, multigroup analysis of variance, correlation analysis by Spearman correlation, and risk factor assessment by ordered logistic regression analysis.

Research results

The betatrophin/ANGPTL3/LPL pathway is positively correlated with the severity of CAD. The levels of serum betatrophin and ANGPTL3 in the Kazakh CHD group with severe CAD were significantly higher than those in the Han CHD group with severe CAD. However, there was no significant difference in serum LPL levels in patients with mild CAD. Logistic regression analysis revealed that TG and serum betatrophin were risk factors for coronary atherosclerosis in Kazakh patients, and BMI and serum betatrophin were risk factors for coronary atherosclerosis in Han patients. Other expression mechanisms of betatrophin in lipid regulation still need to be explored. The inflammatory response and autophagy mediated by betatrophin in atherosclerosis may become a new research direction.

Research conclusions

There was a correlation between the betatrophin/ANGPTL3/LPL pathway and severity of CAD in patients with CHD.

Research perspectives

The expression of betatrophin in other tissues and its new mechanism of lipid regulation, as well as the inflammatory response and autophagy of atherosclerosis mediated by betatrophin may become new research directions. Not only that, betatrophin can also be used as a target for new lipid regulation treatments to provide clues for the development of new drugs.