Inflammation mediates the relationship between cardiometabolic index and vulnerable plaque in patients with acute coronary syndrome.

IF 3.9 2区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Lipids in Health and Disease Pub Date : 2025-05-28 DOI:10.1186/s12944-025-02608-4

Haihao Yan, Sai Lv, Haiyao Pi, Haixu Yu, Weijun Yin, Yaran Wang, Yonghao Lan, Wei Liu

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Abstract

Background: As a novel indicator reflecting metabolic status and visceral adiposity distribution, the cardiometabolic index (CMI) has gained attention in cardiovascular risk stratification. This investigation employed optical coherence tomography (OCT) to examine potential associations between CMI and vulnerable plaque, as well as the role of inflammation.

Methods: This study conducted a cross-sectional analysis of 270 acute coronary syndrome (ACS) patients who had OCT imaging evaluation. Patients were categorized based on CMI tertiles, with CMI calculated using the formula [waist (cm)/height (cm)]×[triglycerides (mmol/L)/HDL-C (mmol/L)]. OCT was used to assess plaque events in culprit lesions and plaque components in non-culprit lesions, and inflammatory markers were measured. A mediation analysis framework was implemented to investigate inflammatory pathways in CMI-vulnerable plaque relationships.

Results: CMI tertiles were linked to vulnerable plaque traits: thin-cap fibroatheromas (TCFA), macrophages (Tertiles1 vs. Tertiles2 vs. Tertiles3, TCFA: 10.0% vs. 20.0% vs. 26.7%, P = 0.016; macrophages: 17.8% vs. 28.9% vs. 36.7%, P = 0.019). Multivariate regression demonstrated CMI elevation independently predicted a higher prevalence of TCFA (OR:1.40, 95%CI: 1.25-2.89, P = 0.003), more macrophage infiltration (OR:1.61, 95% CI:1.09-2.37, P = 0.017), reduced FCT (β:-30.65, 95% CI:-50.72-10.57, P = 0.003), and enlarged maximum lipid arc (β:20.78, 95% CI:6.55-35.01, P = 0.004). Moreover, CMI was positively related to hsCRP, WBC, and neutrophils. Mediation analysis revealed that hsCRP mediated about 17.0% of the association between CMI and minimum FCT [Indirect effect=-5.21, 95% CI=(-12.70, -1.27), P = 0.016].

Conclusions: CMI is a key forecaster of vulnerable plaque in patients with ACS. Systemic inflammation is associated with the relationship between CMI and vulnerable plaque features, suggesting a potential mechanistic link.

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炎症介导急性冠状动脉综合征患者心脏代谢指数与易损斑块的关系

背景：心血管代谢指数（cardimetabolic index， CMI）作为一种反映代谢状态和内脏脂肪分布的新指标，在心血管危险分层中受到关注。本研究采用光学相干断层扫描（OCT）来检查CMI与易损斑块之间的潜在关联，以及炎症的作用。方法：本研究对270例急性冠脉综合征（ACS）患者进行了横断面分析。根据CMI分位数对患者进行分类，CMI计算公式为[腰围(cm)/身高（cm）]×[甘油三酯(mmol/L)/HDL-C (mmol/L)]。OCT用于评估罪魁祸首病变中的斑块事件和非罪魁祸首病变中的斑块成分，并测量炎症标志物。采用中介分析框架来研究cmi易损斑块关系中的炎症途径。结果：CMI ttile与易损斑块特征相关：薄帽纤维动脉粥样瘤（TCFA），巨噬细胞(Tertiles1 vs. Tertiles2 vs. Tertiles3, TCFA: 10.0% vs. 20.0% vs. 26.7%, P = 0.016；巨噬细胞:17.8%比28.9%比36.7%,P = 0.019)。多因素回归显示，CMI升高独立预测TCFA患病率升高（OR:1.40, 95%CI: 1.25-2.89, P = 0.003），巨噬细胞浸润增加（OR:1.61, 95%CI: 1.09-2.37, P = 0.017）， FCT降低（β:-30.65, 95%CI: -50.72-10.57, P = 0.003），最大脂质弧增大（β:20.78, 95%CI: 6.55-35.01, P = 0.004）。此外，CMI与hsCRP、WBC和中性粒细胞呈正相关。中介分析显示，hsCRP介导了CMI和最小FCT之间约17.0%的关联[间接效应=-5.21,95% CI=(-12.70, -1.27), P = 0.016]。结论：CMI是ACS易损斑块的重要预测指标。全身性炎症与CMI和易损斑块特征之间的关系有关，提示存在潜在的机制联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lipids in Health and Disease 生物-生化与分子生物学

CiteScore

7.70

自引率

2.20%

发文量

122

审稿时长

3-8 weeks

期刊介绍： Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.