LOX index, a novel predictive biochemical marker for coronary heart disease and stroke.
BACKGROUND
Lectin-like oxidized LDL receptor 1 (LOX-1) is implicated in atherothrombotic diseases. Activation of LOX-1 in humans can be evaluated by use of the LOX index, obtained by multiplying the circulating concentration of LOX-1 ligands containing apolipoprotein B (LAB) times that of the soluble form of LOX-1 (sLOX-1) [LOX index = LAB x sLOX-1]. This study aimed to establish the prognostic value of the LOX index for coronary heart disease (CHD) and stroke in a community-based cohort.


METHODS
An 11-year cohort study of 2437 residents age 30-79 years was performed in an urban area located in Japan. Of these, we included in the analysis 1094 men and 1201 women without history of stroke and CHD. We measured LAB and sLOX-1 using ELISAs with recombinant LOX-1 and monoclonal anti-apolipoprotein B antibody and with 2 monoclonal antibodies against LOX-1, respectively.


RESULTS
During the follow-up period, there were 68 incident cases of CHD and 91 cases of stroke (with 60 ischemic strokes). Compared with the bottom quartile, the hazard ratio (HR) of the top quartile of LOX index was 1.74 (95% CI 0.92-3.30) for stroke and 2.09 (1.00-4.35) for CHD after adjusting for sex, age, body mass index, drinking, smoking, hypertension, diabetes, non-HDL cholesterol, and use of lipid-lowering agents. Compared with the bottom quartile of LOX index, the fully adjusted HRs for ischemic stroke were consistently high from the second to the top quartile: 3.39 (95% CI 1.34-8.53), 3.15 (1.22-8.13) and 3.23 (1.24-8.37), respectively.


CONCLUSIONS
Higher LOX index values were associated with an increased risk of CHD. Low LOX index values may be protective against ischemic stroke.
Inoue
Nobutaka
N
Department of Vascular Physiology, National Cardiovascular Center, Osaka, Japan.
Okamura
Tomonori
T
Kokubo
Yoshihiro
Y
Fujita
Yoshiko
Y
Sato
Yuko
Y
Nakanishi
Mamoru
M
Yanagida
Kazuki
K
Kakino
Akemi
A
Iwamoto
Shin
S
Watanabe
Makoto
M
Ogura
Sayoko
S
Otsui
Kazunori
K
Matsuda
Haruo
H
Uchida
Kagehiro
K
Yoshimoto
Ryo
R
Sawamura
Tatsuya
T
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology; D000937:Antigen-Antibody Reactions; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000097:blood / Q000276:immunology; D012307:Risk Factors; D051127:Scavenger Receptors, Class E / Q000097:blood* / Q000276:immunology; D020521:Stroke / Q000097:blood*
D000911:Antibodies, Monoclonal; D015415:Biomarkers; C495137:OLR1 protein, human; D011994:Recombinant Proteins; D051127:Scavenger Receptors, Class E