Background

Aberrations in endothelial cells, immune and oxidative pathways are associated with atherosclerosis (ATS) and unstable angina (UA). The role of trace elements, minerals, and the endogenous opioid system (EOS) in UA are less well established.

Methods

We measured lipid, insulin resistance (IR), and immune, trace element (copper and zinc), mineral (magnesium, calcium), EOS (β-endorphin and mu-opioid receptor (MOR)) and antioxidant (vitamin D3) biomarkers in patients with ATS (n = 60) and UA (n = 60) and healthy controls (n = 58).

Results

ATS patients showed increased atherogenic and IR indices, IL-6, IL-10, β-endorphin, copper and magnesium, and lower zinc than healthy controls. Logistic regression showed that UA was significantly discriminated from ATS without UA with an accuracy of 85.5 % using calcium, IL-10, β-endorphin, MOR, triglycerides, IR (all positively), and copper and vitamin D3 (inversely). Neural networks showed that UA was discriminated from ATS without UA with an area under the ROC curve of 0.942 using MOR, β-endorphin, calcium, insulin resistance, vitamin D3 and copper as input variables. We found that 50.0 % of the variance in IR was explained by the regression on copper, IL-10, IL-6 (all positively), and zinc (inversely), while 32.9 % of the variance in the atherogenic index of plasma was explained by copper, IL-10 (both positively), and magnesium (inversely).

Conclusion

UA is not only mediated by insulin resistance, atherogenicity, and immune disorders, but also by aberrations in the endogenous opioid system and trace elements as well as lowered antioxidant levels. Copper appears to play a key role in IR and atherogenicity.

中文翻译：

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不稳定心绞痛的微量元素、免疫和阿片类生物标志物、增加的动脉粥样硬化和胰岛素抵抗：机器学习的结果

背景

内皮细胞、免疫和氧化途径的异常与动脉粥样硬化 (ATS) 和不稳定型心绞痛 (UA) 相关。微量元素、矿物质和内源性阿片类药物系统 (EOS) 在 UA 中的作用尚不明确。

方法

我们测量了脂质、胰岛素抵抗 (IR) 和免疫、微量元素（铜和锌）、矿物质（镁、钙）、EOS（β-内啡肽和 mu-阿片受体（MOR））和抗氧化剂（维生素 D3）生物标志物。患有 ATS (n = 60) 和 UA (n = 60) 的患者以及健康对照 (n = 58)。

结果

与健康对照组相比，ATS 患者的动脉粥样硬化和 IR 指数、IL-6、IL-10、β-内啡肽、铜和镁以及锌含量降低。Logistic 回归显示，使用钙、IL-10、β-内啡肽、MOR、甘油三酯、IR（全部为正）以及铜和维生素 D3（相反），UA 与没有 UA 的 ATS 有显着区别，准确率为 85.5%。神经网络显示，使用 MOR、β-内啡肽、钙、胰岛素抵抗、维生素 D3 和铜作为输入变量，UA 可与无 UA 的 ATS 区分开来，ROC 曲线下面积为 0.942。我们发现 50.0% 的 IR 变异可以通过对铜、IL-10、IL-6（全部为正）和锌（反之）的回归来解释，而 32.9% 的血浆动脉粥样硬化指数方差被解释铜、IL-10（均为正）和镁（反）。

结论

UA 不仅由胰岛素抵抗、致动脉粥样硬化和免疫紊乱介导，还由内源性阿片系统和微量元素的异常以及抗氧化水平降低介导。铜似乎在 IR 和致动脉粥样硬化中起关键作用。