稳定型冠心病血清二十烷酸与冠状动脉粥样硬化斑块不稳定性的相关性研究

Objective This study aimed to screen serum metabolites associated with fibrous cap thickness using untargeted metabolomics and to further validate the candidate metabolite through targeted quantification. Methods Patients with stable coronary artery disease who underwent coronary angiography(CAG) and intravascular ultrasound(IVUS) at Shaanxi Provincial People's Hospital were retrospectively enrolled. Based on the median IVUS-derived fibrous cap thickness, patients were classified into the thin-cap group and the thick-cap group. Untargeted metabolomics was first used to identify differential metabolites between groups. Pearson correlation analyses were then performed to determine metabolites associated with fibrous cap thickness. Candidate metabolites were subsequently quantified using targeted liquid chromatography–tandem mass spectrometry. Multivariable Logistic regression was applied to assess independent associations after adjusting for potential confounders. Results A total of 10 differential metabolites were identified. Pearson correlation analysis revealed that one metabolite, icosanoic acid, was significantly associated with fibrous cap thickness(r=–0.210, P=0.035). Targeted quantification showed higher serum levels of icosanoic acid in the thin-cap group than in the thick-cap group. Multivariable Logistic regression demonstrated that icosanoic acid remained independently associated with thin-cap status after adjustment for multiple clinical covariates. Conclusion Serum icosanoic acid levels are negatively associated with fibrous cap thickness. Icosanoic acid may serve as a potential circulating metabolic indicator for assessing the structural stability of coronary atherosclerotic plaques, with certain clinical application value.