A Study on the Correlation between Circulating Paraoxonase 1 Levels and Coronary Artery Stenosis in Diabetic Patients.

INTRODUCTION

Research has found that paraoxonase 1 (PON1) is closely related to cardiovascular disease, but the relationship between circulating PON1 levels and coronary artery stenosis (CAS) in patients with diabetes remains unclear.

METHODS

This study is a single-center, retrospective cross-sectional study that includes 34 patients with diabetes mellitus (DM) and 118 patients with DM and CAS (DM+CAS). All study participants were from Beijing Luhe Hospital, affiliated with Capital Medical University. In this study, data regarding demographic characteristics, medication history, and key laboratory parameters were collected. The concentration of plasma PON1 was quantified using an enzyme-linked immunosorbent assay (ELISA) kit. Multiple logistic regression models were employed to evaluate the connection between PON1 levels and the presence of CAS among patients with diabetes. Additionally, the diagnostic performance of PON1 levels for diabetes combined with CAS was evaluated utilizing the receiver operating characteristic (ROC) curve and the area under the curve (AUC).

RESULTS

Compared with patients in the diabetes group, plasma PON1 levels were significantly lower in diabetic patients with CAS. To evaluate the correlation between PON1 levels and CAS among individuals with diabetes, three logistic regression models were developed. As a continuous variable, higher PON1 levels were found to be inversely related to CAS risk in all models. In tertile-stratified analyses, compared with T1, all other tertiles exhibited significantly reduced risk of CAS. The ROC curve demonstrated that the unadjusted AUC of PON1 levels was 0.662 (95% CI 0.561-0.762, p = 0.004), while the fully adjusted model yielded an AUC of 0.833 (95% CI: 0.758-0.908, p < 0.001).

DISCUSSION: Plasma PON1 levels were significantly decreased and independently associated with CAS in diabetic patients. Circulating PON1 alone showed moderate diagnostic efficiency, whereas its predictive accuracy was greatly improved when combined with clinical covariates. The findings are limited by single-center enrollment, a small sample size, and a lack of subgroup analysis for stenosis severity. Moreover, only PON1 protein levels were examined, with no detection of PON1 enzymatic activity. Further large-scale multicenter prospective studies are needed to validate these results and clarify the clinical utility of PON1.

CONCLUSION

Circulating PON1 levels are negatively correlated with CAS in diabetic patients. While PON1 alone has limited diagnostic value, its combination with clinical covariates significantly improves risk discrimination.