Tujuan: Membuat kriteria tipe HDL proaterogenik/antiaterogenik berdasarkan konsentrasi Apolipoprotein A-I(ApoA-I), Paraoxonase-1 (PON-1), Neopterin dan HDL-cholesterol.Metode: Penelitian dilakukan secara kontrol-kasus pada 52 subjek dengan sindrom koroner akut (SKA) dan 30 subjekkontrol sehat. Tipe HDL proaterogenik dan antiaterogenik ditentukan berdasarkan konsentrasi ApoA-I, PON-1, Neopterindan HDL-cholesterol. Konsentrasi ApoA-I diukur menggunakan metode imunoturbidimetri, PON-1 diukur dengan metodekolorimetri, Neopterin diukur dengan metode ELISA dan HDL-cholesterol diukur dengan metode homogenous. Analisisregresi logistik univariat dilakukan dengan SKA sebagai variabel tergantung dan konsentrasi ApoA-I, PON-1, Neopterindan HDL-cholesterol sebagai variabel tidak tergantung. Tipe HDL proaterogenik dan antiaterogenik ditentukan denganmenggunakan nilai cut off dan odd ratio ApoA-I, PON-1, Neopterin dan HDL-cholesterol.Hasil: Umur subjek penelitian adalah 50,89 + 12,63 tahun, konsentrasi HDL-cholesterol : 39,82 + 9,84 mg/dL, ApoA-1 : 119,77 + 32,05 mg/dL, PON-1 : 41,26 + 18,19 kU/L, Neopterin : 16,22 + 38,10 nmol/L. Cut off ApoA-I, PON-1dan Neopterin secara berturut-turut adalah 124,5 mg/dL, 40,8 kU/L, and 7,016 nmol/L. Hasil analisis regresi logistikunivariat didapatkan OR untuk ApoA-I, PON-1 dan Neopterin secara berturut-turut 29,759 (95% CI : 4,074 ? 217,382),1,647 (95% CI : 0,412 ? 6,586), 4,317 (95% CI : 1,098 ? 16,977). Dengan sistem scoring, kami menyimpulkan totalscore > 18 menunjukkan tipe HDL proaterogenik, dan total score < 18 merupakan tipe HDL antiaterogenik. Dengansistem scoring ini kami menemukan 78,85% populasi SKA termasuk ke dalam tipe HDL proaterogenik.Kesimpulan: Disfungsi HDL atau tipe HDL proaterogenik/antiaterogenik dapat diperkirakan dengan menggunakan sistemscoring ApoA-I ? PON-1 ? Neopterin ? HDL-cholesterol. Subjek dengan total score < 18 dikelompokkan ke dalam tipe HDLantiaterogenik, sedangkan subjek dengan total score >18 memiliki tipe HDL proaterogenik.
Abstract
Aim: To make proatherogenic/antiatherogenic HDL type criteria using Apolipoprotein A-I (ApoA-I), Paraoxonase-1(PON-1), Neopterin and HDL-cholesterol levels, which may be useful in clinical practice.Methods: This was a case control study recruiting 52 subjects with Acute Coronary Syndrome (ACS) and 30 controlhealthy subjects. HDL type was classifi ed into antiatherogenic and proatherogenic based on the levels of ApoA-I,PON-1, Neopterin and HDL-cholesterol. Concentrations of ApoA-I was measured by immunoturbidimetry method,PON-1 was measured by colorimetric method, Neopterin was measured by ELISA, and HDL-C was determined byhomogenous method. Univariate logistic regression analysis was done using ACS as a dependent variable and levelsof ApoA-I, PON-1, Neopterin and HDL-cholesterol as independent variables. Proatherogenic/antiatherogenic HDLtype was determined by using ApoA-I, PON-1, Neopterin and HDL-cholesterol cut off and odd ratios.Results: Patient?s age was 50.89 + 12.63 year, HDL-C was 39.82 + 9.84 mg/dL, Apo A-1 was 119.77 + 32.05 mg/dL, PON-1 was 41.26 + 18.19 kU/L, Neopterin was 16.22 + 38.10 nmol/L. Cut offs of ApoA-I, PON-1 and Neopterinsuccessively were 124.5 mg/dL, 40.8 kU/L, and 7.016 nmol/L. On univariate logistic regression analysis showed thatOR of ApoA-I, PON-1 and Neopterin respectively were 29.759 (95% CI : 4.074 ? 217.382), 1.647 (95% CI : 0.412 ?6.586), 4.317 (95% CI : 1.098 ? 16.977). Using scoring system, we concluded that total score > 18 was proatherogenicHDL type, and total score < 18 was antiatherogenic HDL type. With this scoring we found 78.85% had proatherogenicHDL type in ACS population.Conclusions: Dysfunctional HDL or proatherogenic/antiatherogenic HDL type can be predicted by using ApoA-I ?PON-1 ? Neopterin ? HDL-cholesterol scoring system. Those with score of 18 are supposed to have antiatherogenicHDL type, and those with score of > 18 were having proatherogenic HDL type. |
