This study examined the associations between emerging lipid biomarkers (small dense low-density lipoprotein cholesterol [sdLDL-C), lipoprotein(a) [Lp(a)], and free fatty acids [FFA]), two ratios (sdLDL-C/LDL-C and the triglyceride–glucose [TyG) index), and the Gensini score (GS) in patients with premature coronary artery disease (PCAD) in relation to the extent of coronary stenosis. The authors evaluated a cohort of 2952 individuals undergoing coronary angiography (CAG), encompassing those with PCAD (n = 1749), late-onset coronary artery disease (LCAD; n = 328), and non-coronary artery disease (non-CAD; n = 575). Noteworthy differences were observed in the levels of the novel lipid biomarkers and ratio indexes among the PCAD, LCAD, and non-CAD groups (p < .05). Multiple logistic regression analyses pinpointed Lp(a) (OR = 2.62, 95% CI 1.22–5.63, p = .014) and the TyG index (OR = 2.53, 95% CI 1.08–5.93, p = .033) as independent risk factors for PCAD. Furthermore, these biomarkers and ratio indexes discerned substantial distinctions among PCAD patients with varying GS (p < .05). Consequently, these markers can proficiently anticipate the gravity of coronary artery stenosis (GS > 40) in PCAD patients, as evidenced by the ROC analysis. In conclusion, sdLDL-C, Lp(a), FFA, and the sdLDL-C/LDL-C and TyG indexes have considerable potential as risk and diagnostic markers for coronary artery stenosis in individuals afflicted with PCAD.

中文翻译：

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作为早发冠状动脉疾病风险预测因子的新型脂质生物标志物和比率：对 2952 名患者的回顾性分析

本研究检查了新兴脂质生物标志物（小密度低密度脂蛋白胆固醇 [sdLDL-C]、脂蛋白（a）[Lp(a)] 和游离脂肪酸 [FFA]）、两个比率（sdLDL-C/ LDL-C 和甘油三酯-葡萄糖 [TyG] 指数）以及早发冠心病 (PCAD) 患者的 Gensini 评分 (GS) 与冠状动脉狭窄程度的关系。作者评估了 2952 名接受冠状动脉造影 (CAG) 的个体，其中包括患有 PCAD ( n  = 1749)、迟发性冠状动脉疾病 (LCAD；n  = 328) 和非冠状动脉疾病 (non-CAD；n = 328) 的患者。n  = 575）。PCAD、LCAD 和非 CAD 组之间新型脂质生物标志物和比率指数的水平存在显着差异 ( p  < .05)。多重逻辑回归分析确定 Lp(a)（OR = 2.62，95% CI 1.22–5.63，p  = .014）和 TyG 指数（OR = 2.53，95% CI 1.08–5.93，p  = .033）为独立风险PCAD 的因素。此外，这些生物标志物和比率指数辨别出具有不同 GS 的 PCAD 患者之间的显着差异 ( p  < .05)。因此，这些标志物可以熟练地预测 PCAD 患者冠状动脉狭窄的严重程度 (GS > 40)，如 ROC 分析所证明的那样。总之，sdLDL-C、Lp(a)、FFA 以及 sdLDL-C/LDL-C 和 TyG 指数作为患有 PCAD 的个体冠状动脉狭窄的风险和诊断标志物具有相当大的潜力。