Decreased serum levels of thioredoxin in patients with coronary artery disease plus hyperhomocysteinemia is strongly associated with the disease severity

  • Author Footnotes
    1 These authors contributed equally to this work.
    Yunfei Wu
    1 These authors contributed equally to this work.
    College of Life Sciences, Graduate University of Chinese Academy of Sciences, Yuquan Road 19(A), 100049 Beijing, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Lijuan Yang
    1 These authors contributed equally to this work.
    Department of Endocrinology, Chinese PLA General Hospital, 100853 Beijing, China
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  • Liangwei Zhong
    Corresponding author. Tel.: +86 10 88256266; fax: +86 10 88256266.
    College of Life Sciences, Graduate University of Chinese Academy of Sciences, Yuquan Road 19(A), 100049 Beijing, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.



      Elevation of homocysteine and thioredoxin (Trx) levels was found in some patients with coronary artery diseases (CAD). However, their correlations with CAD were not clear. Dysfunction of thioredoxin/thioredoxin reductase (TrxR) may cause oxidative stress that is common to CAD. We seek to determine the association among homocysteine, Trx/TrxR and CAD.


      Serum samples were collected from 150 CAD patients under statin treatment and 122 non-CAD controls. Risk factors for atherosclerosis including homocysteine, lipids and glucose levels were analyzed. Trx/TrxR activities and protein levels were determined using super-insulin assay and Western blot, respectively. One-way ANOVA, Tukey's post hoc test and Spearman's rank correlation coefficient were used for statistical analysis. CAD severity was evaluated by angiographic Gensini score.


      Compared with non-CAD group, CAD group had significantly increased TrxR activity (P < 0.05) and homocysteine levels (P < 0.01), but not Trx activity. After further dividing CAD group using homocysteine below 15 μM as reference, Trx activity decreased significantly in CAD group with high homocysteine, and was inversely associated with homocysteine levels (r = −0.199, P < 0.05) that was, however, weakly positively associated with TrxR activity. Neither lipids nor glucose significantly affected Trx/TrxR activity. Association of CAD severity with low Trx plus high homocysteine was strong (r = −0.458, P < 0.001), but with high homocysteine alone was rather weak (r = 0.125, P = 0.225).


      In CAD patients, high homocysteine levels may cause low Trx activity, which is closely correlated to the extent and severity of CAD.


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