[The miR-184 level in the seminal plasma exosome of male infertility patients and its clinical significance].

OBJECTIVE: To study the miR-184 level in the seminal plasma exosome of male infertility patients and its clinical significance. METHODS: Between 2015 and 2019, we collected 285 seminal plasma samples from 97 azoospermia (AS) and 96 asthenospermia (AZS) patients and 92 age-matched normal fertile controls in Jiangsu Provincial Hospital of Traditional Chinese Medicine, General Hospital of Eastern Theater Command and the First Hospital Affiliated to Wenzhou Medical University, identified the isolated seminal plasma exosomes by nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM) and Western blot, and detected the miR-184 level in the seminal plasma exosomes by quantitative real-time PCR (qRT-PCR). We determined the clinical value of the miR-184 level and its correlation with semen parameters by multiple statistics, predicted the target genes and involved pathways of miR-184 by bioinformatic algorithms, and analyzed their relationship with male infertility. RESULTS: NTA, TEM and Western blot exhibited plenty of exosomes in the seminal plasma of the patients. The results of qRT-PCR showed that the miR-184 level in the seminal plasma exosome was dramatically decreased in the AS patients compared with that in the normal fertile controls (0.227 ［0.092, 0.790］ vs 0.650 ［0.408, 1.061］, P < 0.01), but increased in AZS males in comparison with that in the control group (1.176 ［0.661, 1.946］ vs 0.650 ［0.408, 1.061］, P < 0.01). The areas under the ROC curve (AUC) for differentiating the AS and AZS patients from the controls were 0.866 (95% CI: 0.815－0.916) and 0.724 (95% CI: 0.653－0.795), respectively, and that for differentiating the AS from the AZS group was 0.964 (95% CI: 0.943－0.985). The miR-184 level in the seminal plasma exosome of the AZS patients was correlated positively with the sperm count (r = 0.243, P = 0.017) but negatively with the percentage of progressively motile sperm (r = －0.407, P = 0.006). Bioinformatics analysis indicated that the downstream target genes of miR-184 were significantly enriched in the protein regulatory pathways closely related to male reproduction and spermatogenesis. CONCLUSIONS: The miR-184 level in the seminal plasma exosome of infertility patients is significantly different from that of normal fertile males, which may serve as a potential auxiliary marker for the diagnosis of and participate in the development and progression of male infertility.

[Relationship of small non-coding RNA in the seminal plasma with male infertility: An update].

The incidence of male infertility is increasing year by year, but there is a lack of non-invasive accurate diagnostic indicators for this disease, and the pathogenesis of idiopathic infertility is not yet fully clarified. Recent studies have found that there are various small non-coding RNAs (sncRNA) in the human seminal plasma and spermatic exosomes, which can be used as a novel non-invasive biomarker of male infertility. This review outlines the latest research updates on the relationship between sncRNAs in the seminal plasma and male infertility, aiming to provide some new ideas for the screening of the molecular markers of male infertility and study of its underlying molecular mechanisms.

[Difference of alkaloid components between old stems and tender stems of Gelsemium elegans].

This study aimed to comprehensively assess the difference of alkaloid components between old stems and tender stems of Gelsemium elegans by using ultra high-performance liquid chromatography coupled with photo-diode array and quadrupole time-of-flight mass spectrometry( UPLC-Q-TOF/MS~E) and high-performance liquid chromatography coupled with UV detector( HPLC-UV). Firstly,the different components in old stems and tender stems were analyzed by UHPLC-Q-TOF/MSEcombined with principal component analysis( PCA) and orthogonal partial least squares discriminant analysis( OPLS-DA),respectively. As a result,17 major different components were found. At the same time,the distribution of these alkaloids in old stems and tender stems was determined,and the alkaloids with higher polarity are relatively higher in the tender stems,while the old stems are in the opposite case. In addition,three main components in the G. elegans were quantified by HPLC-UV. The results showed that the contents of koumine and humantenmine in old stems were higher than those in tender stems,and the content of gelsemine in tender stems was relatively high. This study systematically evaluated the differences of alkaloids between the old stems and tender stems of G. elegans,and quantified the main three alkaloids. It laid the foundation of the safe and effective application of G. elegans.

Expression of AQP2, AQP4 and AQP 8 in mouse intestine induced by unprocessed and processed Euphorbia lathyris.

The present research was designed to study expression of AQP2, AQP4 and AQP8 in mouse intestines induced by unprocessed and processed Euphorbia lathyris. KM mice were given by different dose lavage of unprocessed and processed Euphorbia lathyris, Euphorbia factor L1, Euphorbia factor L2, Euphorbia factor L3. Samples of mouse intestine were collected for protein levels of AQP2, AQP 4 and AQP 8 which were assessed by immunohistochemical staining and mRNA expression of AQP2, AQP 4 and AQP 8 which were quantified by Real Time-PCR. Comparing to the normal control group, the protein levels of AQP2, AQP 4 and AQP 8 were significantly decreased (P<0.05)by Semen Euphorbiae group and Semen Euphorbiae Pulveratum group (unprocessed and processed Euphorbia lathyris) induced. Protein expression of AQP2, AQP 4 and AQP 8 in the Euphorbia factor L1, Euphorbia factor L2 and Euphorbia factor L3 group were not significantly lower than normal control group. There had no differences on the levels of AQP2 and AQP 8 mRNA expressions between the high-dose group of semen Euphorbiae group, semen Euphorbiae Pulveratum group and positive control group, while significantly lower than normal control group (P<0.05). Expression of AQP4 mRNA in the Semen Euphorbiae group and Semen Euphorbiae Pulveratum group has not significantly decreased. But levels of AQP2, AQP 4 and AQP 8 mRNA in the Euphorbia factor L1 group had no significant differences in normal control group and positive control group. These findings suggest that semen Euphorbiae could regulate expression of AQP2, AQP 4 and AQP 8 protein and mRNA, which may be the possible one reason of semen Euphorbiae induces diarrhea. The semen Euphorbiae group has more significant effects on the levels of AQP2, AQP 4 and AQP 8 protein and mRNA than semen Euphorbiae Pulveratum group, which may be one of the mechanisms of processing attenuation.

[Chromatographic fingerprint analysis of Toosendan Fructus by HPLC-CAD coupled with chemometrics methods].

A new method was developed for the chromatographic fingerprint analysis of Toosendan Fructus by HPLC coupled with the charged aerosol detector (CAD) in the present study. Samples were well separated on an Agilent ZOBAX SB C18 column (4.6 mm × 250 mm, 5 µm) by gradient elution using acetonitrile and water containing 0.1 % formic acid (v/v) at the flow rate of 1.0 mL·min−1. The column temperature was 30 ℃ and the injection volume was 5 µL. The nitrogen inlet pressure of the charged aerosol detector (CAD) was 35 psi, and the nebulizer chamber temperature was 35 ℃. In addition, the method of the chromatographic fingerprints combined with multivariate statistical analysis was effective and reasonable lead to an accurate classification of 20 batches of samples from different locations. The results showed that 28 common peaks were observed in the fingerprint and the samples were classified into three clusters. The established method was well validated, and showed high precision, good repeatability, and satisfactory stability. It may serve in the quality control and evaluation of Toosendan Fructus.

[MicroRNAs in seminal plasma: an update].

MicroRNAs (miRNAs), present abundantly in human body fluids, may serve as biomarkers for the diagnosis of a variety of diseases. Recent studies show that they are also abundantly and stably expressed in the seminal plasma of men. Some seminal plasma-specific miRNAs can be used as potential markers for forensic body fluid identification. Furthermore, the expression profile of seminal plasma miRNAs in normal fertile men is quite different from that in idiopathic infertile patients. The specifically altered profile of seminal plasma miRNA is closely related with male infertility and spermatogenic dysfunction and therefore can be used as a novel biomarker for the diagnosis of male infertility. A deeper insight into the specific changes of seminal miRNA may point a new direction in the studies of the molecular mechanisms of male infertility.

[The clinical significance of serum free light chain in primary systemic amyloidosis].

OBJECTIVE: To evaluate the diagnostic and therapeutic significance of serum free light chain (sFLC) in primary systemic(AL) amyloidosis. METHODS: Twenty-five patients with AL amyloidosis, including 18 men and 7 women with a mean age of 54 (47 - 77) years old, were enrolled from October, 2005 to May, 2010. sFLC was measured by immunoturbidimetric assay. The type of monoclonal light chain was judged upon sFLC κ/λ and its sensibility was compared with serum immunofixation and immunohistochemical analysis. Four patients were treated with M(T)D (melphalan/thalidomide,and dexamethasone), one with VD (velcade and dexamethasone) and four with high-dose melphalan followed by autologous stem cell support. The changes of sFLC were serially determined before and after treatment. RESULTS: Among the 25 patients with AL amyloidosis, two were κ light chains of precursor protein and 23 were λ light chains. Mean plasma cell in bone marrow was 3.5% (0 - 15%). Nineteen (76%) patients had abnormal elevated sFLC and abnormal κ/λ ratios, and 17(68%) patients with immunofixation positive. The sFLC test had similar sensitivity as serum immunofixation (P = 0.727). Twenty-one (84%) patients were shown to have either κ or λ immunoreactive amyloid deposits on biopsied tissues. The sFLC test combined with serum immunofixation allowed the M protein to be detected in 22 (88%) patients. The positive rates of immunohistochemical analysis combined with sFLC test and/or serum immunofixation were 96%. Four patients with hematologic response showed obvious improvement in visceral organ involvement, but illness of 5 patients without hematologic response kept stable or progressed. CONCLUSIONS: sFLC test is a sensitive qualitative and quantitative method to detect M protein. Preliminary data show the patients with obvious sFLC level decrease and/or κ/λ recovery to normal may have a high percentage of improved organs function. sFLC is critical index in diagnosing AL amyloidosis, which might help efficacy assessment.

[MicroRNAs and prostate cancer].

MicroRNAs (miRNAs), with the length of about 22 nucleotides, are a growing family of small non-protein-coding RNAs that function as post-transcriptional regulators of target genes, involved in multiple processes of life and closely related with tumorigenesis. Recently, some aberrantly expressed miRNAs have been discovered in the prostate, indicating that miRNA may play a critical role in the molecular mechanism of the pathogenesis of prostate cancer. With deeper studies on human serum and plasma miRNAs, serum miRNA is promising to be a potential diagnostic biomarker for prostate cancer.

[Updated relationship between microRNA and reproduction].

MicroRNAs (miRNAs) are a class of non-coding single-stranded RNA molecules, about 22 nucleotides in length, and highly conserved in evolution. They participate in a variety of important biological processes, including the development, differentiation, and apoptosis of eukaryotes. Recent studies have discovered that miRNAs play important roles in the development of primordial germ cells, spermatogenesis, and the process of fertilization.

[Down-regulation of PGC-1alpha expression in human hepatocellular carcinoma].

OBJECTIVE: To study the effect of PGC-1alpha in human liver carcinogenesis, and explore the regulatory role of PGC-1alpha in the development of liver cancer. METHODS: The changes of PGC-1alpha mRNA level in normal human liver tissues and human liver tumors was examined by quantitative RT-PCR. PGC-1alpha mRNA level was interfered by siRNA in human liver cell line L02 in vitro, and their morphological changes were observed by pathology with HE staining. The ultrastructure of cells was observed by electron microscopy. In addition, the gene expression pattern of decreasing PGC-1alpha in L02 cells and liver tumor tissue was compared by human genome 70-mer oligonucleotide microarray analysis. RESULTS: PGC-1alpha expression was weaker in the malignant liver tumors compared with that in normal liver tissues. When PGC-1alpha expression was suppressed in human liver L02 cells, the cells became smaller with enlarged nuclei, and myelin figures were observed in mitochondria by electron microscopy, similar with the ultrastructure of liver cancer cells. Microarray analysis showed that the decrease of PGC-1alpha in L02 cells induced up-regulation of some oncogenes and adhesive genes, and down-regulation of a number of tumor suppressor genes and cell proliferation suppressor genes. The changes of decreasing expression pattern of PGC-1alpha gene in L02 cells were similar to those in human liver cancer tissue. CONCLUSION: The results of the present study show that PGC-1alpha is down-regulated in liver cancers and is involved in the malignant transformation in human normal liver cells in vitro, suggesting an important regulatory role of PGC-1alpha in the development of liver cancer.

Distinctive expression signatures of serum microRNAs in ischaemic stroke and transient ischaemic attack patients.

Circulating microRNAs (miRNAs) have recently emerged as promising biomarkers for ischaemic stroke (IS). However, the expression patterns of specific miRNAs in transient ischaemic attack (TIA) patients have not been investigated. Their predictive values for the presence of IS and TIA and their relationships to the neurological deficit severity of IS and the subsequent stroke risk after TIA remain unclear exactly. In this study, 754 miRNAs were initially screened by the TaqMan Low Density Array (TLDA) in two pooled serum samples from 50 IS patients and 50 controls. Markedly altered miRNAs were subsequently validated by individual quantitative reverse-transcription PCR (qRT-PCR) assays first in the same cohort of TLDA and further confirmed in another larger cohort including 177 IS, 81 TIA patients and 42 controls. Consequently, TLDA screening showed that 71 miRNAs were up-regulated and 49 miRNAs were down-regulated in IS patients. QRT-PCR validation confirmed that serum levels of miR-23b-3p, miR-29b-3p, miR-181a-5p and miR-21-5p were significantly increased in IS patients. Strikingly, serum levels of miR-23b-3p, miR-29b-3p and miR-181a-5p were also significantly elevated in TIA patients. Furthermore, up-regulated miR-23b-3p, miR-29b-3p and miR-21-5p could clearly differentiate between IS and TIA patients. Logistic regression and receiver-operating characteristic curve analyses demonstrated that these altered miRNAs may function as predictive and discriminative biomarkers for IS and TIA, and their distinctive expression signatures may contribute to assessing neurological deficit severity of IS and subsequent stroke risk after TIA.

Studies of the microbial metabolism of flavonoids extracted from the leaves of Diospyros kaki by intestinal bacteria.

Flavonoid glycosides are metabolized by intestinal bacteria, giving rise to a wide range of phenolic acids that may exert systemic effects in the body. The microbial metabolism of flavonoids extracted from the leaves of Diospyros kaki (FLDK) by intestinal bacteria was investigated in vitro. High-performance liquid chromatography/linear trap quadrupole orbitrap mass spectrometry was performed to analyze the metabolites of flavonoids in vivo using Xcalibur2.1 software. The results showed that the levels of flavonoid glycosides and flavonoid aglycones decreased rapidly in the process of microbial metabolism by intestinal bacteria in vitro, and the metabolic rate may be related to the concentration of intestinal bacteria in the culture solution. In vivo metabolites of FLDK were detected in rat plasma and urine after oral administration of FLDK. Eight flavonoids were identified in the urine, and three were identified in the plasma; however, flavonoid aglycones were not found in the plasma.

Elevated serum ß2-glycoprotein-I-lipoprotein(a) complexes levels are associated with the presence and complications in type 2 diabetes mellitus.

AIMS: To examine the serum levels of ß2-glycoprotein I-lipoprotein(a) complexes [ß2-GPI-Lp(a)] in type 2 diabetes mellitus (T2DM) patients and evaluate the association of the complexes with complications in T2DM. METHODS: Fifty two T2DM patients (22 with complications and 30 free of complications) and 52 age/gender-matched healthy controls were studied. Serum concentrations of ß2-GPI-Lp(a) and ox-Lp(a) were measured by "sandwich" ELISAs and their associations with complications were examined using multiple linear regression. RESULTS: Mean serum ß2-GPI-Lp(a) (1.19 ± 0.30 U/mL vs. 0.89 ± 0.20 U/mL, p<0.001) and ox-Lp(a) concentrations (13.34 ± 11.73 mg/L vs. 5.26 ± 3.34 mg/L, p<0.001) were both significantly higher in T2DM than in controls. The area under the ROC curve (AUC) for ß2-GPI-Lp(a) and ox-Lp(a) was 0.725 and 0.738, respectively. ß2-GPI-Lp(a) levels were markedly higher in patients with complications than those without complication (1.39 ± 0.28 U/mL vs. 1.04 ± 0.31 U/mL, p<0.01), whereas no marked difference was found in ox-Lp(a). In multivariate regression analysis, the association between ß2-GPI-Lp(a) and complications remained significant (ß=0.249, p<0.05, respectively) after adjustments were made for other traits. CONCLUSIONS: Elevated ß2-GPI-Lp(a) may reflect chronic underlying pathophysiological processes involved in development of complications of T2DM.

Lipoprotein(a) complexes with beta2-glycoprotein I in patients with coronary artery disease.

AIM: To investigate the possible mechanisms and association of increased complexes of ß(2)-glycoprotein I with lipoprotein(a) [ß(2)-GPI-Lp(a)] levels with the presence and extent of coronary artery disease (CAD). METHODS: ß(2)-GPI-Lp(a) levels were measured in 116 patients with acute coronary syndromes (ACS), 72 patients with stable CAD and 100 control subjects. RESULTS: Compared to the control, ß(2)-GPI-Lp(a) levels (expressed after logarithmically transformation: ACS, 0.22±0.45 U/mL; stable CAD, 0.05±0.55 U/mL; control, -0.31±0.61 U/mL) significantly increased in both patients with ACS (p <0.001) and stable CAD (p <0.001). Univariate logistic regression analysis of risk factors revealed that the presence of ß(2)-GPI-Lp(a), ox-Lp(a) or Lp(a) was a strong risk factor for stable CAD [ß(2)GPI-Lp(a), OR 3.17, 95% CI 1.65, 6.07; ox-Lp(a), OR 2.54, 95% CI 1.33, 4.85; Lp(a), OR 3.00, 95% CI 1.56, 5.75; respectively], and especially for ACS [ß(2)-GPI-Lp(a), OR 5.38, 95% CI 2.97, 9.74; ox-Lp(a), OR 7.55, 95% CI 4.12, 13.84; Lp(a), OR 4.33, 95% CI 2.40, 7.80; respectively]. In multivariate analysis, adjusting for age, sex and plasma lipid levels, the presence of ß(2)-GPI-Lp(a) or Lp(a) was a risk factor for both stable CAD and ACS. Ox-Lp(a) was a risk factor only for ACS, while not for stable CAD. ß(2)-GPI-Lp(a) levels were found to be positively associated with Lp(a), ox-Lp(a), maximal stenosis and a number of vessel diseases in patients with ACS or stable CAD, respectively. Multiple linear regression analysis found that ox-Lp(a) and maximal stenosis accounted for 46.2% of the variation in ß(2)-GPI-Lp(a) levels. CONCLUSIONS: Elevated levels of ß(2)-GPI-Lp(a) are associated with the presence and severity of CAD, and may be a strong risk factor for atherosclerosis.

Association among retinol-binding protein 4, small dense LDL cholesterol and oxidized LDL levels in dyslipidemia subjects.

OBJECTIVES: To investigate retinol-binding protein 4 (RBP4), small dense low-density lipoprotein cholesterol (sdLDL-C) and oxidized low-density lipoprotein (ox-LDL) levels and their associations in dyslipidemia subjects. DESIGN AND METHODS: We determined RBP4, sdLDL-C, ox-LDL levels in 150 various dyslipidemia subjects and 50 controls. The correlation analysis and multiple linear regression analysis were performed. RESULTS: The RBP4, sdLDL-C and ox-LDL levels were found increased in various dyslipidemia subjects. The sdLDL-C levels were positively correlated with RBP4 (r=0.273, P=0.001) and ox-LDL (r=0.273, P=0.001). RBP4 levels were also correlated with ox-LDL (r=0.167, P=0.043). The multiple regression analysis showed that only sdLDL-C was a significant independent predictor for RBP4 (ß coefficient=0.219, P=0.009; adjusted R(2)=0.041) and ox-LDL (ß coefficient=0.253, P=0.003; adjusted R(2)=0.057) levels, respectively. CONCLUSIONS: The independent associations of sdLDL-C with RBP4 and ox-LDL were observed in dyslipidemia subjects. RBP4 may play an important role in lipid metabolism of atherosclerosis, particularly in formation of sdLDL.

The level of native and oxidized lipoprotein(a) in children with nephrotic syndrome.

OBJECTIVE: To investigate lipoprotein(a) [Lp(a)], oxidized Lp(a) [ox-Lp(a)] and Lp(a) immune complex [Lp(a)-IC] levels in children with nephrotic syndrome (NS). DESIGN AND METHODS: Plasma Lp(a), ox-Lp(a) and Lp(a)-IC levels were determined in 106 NS children in acute-period, 42 in remission and 155 controls. RESULTS: Lp(a) and ox-Lp(a) levels were significantly higher in acute-period and remission NS than in control. Ox-Lp(a) levels in acute-period NS were higher than in remission. Lp(a)-IC levels in acute-period NS were higher than in control. Lp(a), ox-Lp(a) and Lp(a)-IC were found negatively related with albumin in NS. Lp(a), ox-Lp(a) and Lp(a)-IC levels decreased after use of steroid therapy. Multiple linear regression analysis found relative change of albumin, creatinine, urea, triglyceride and high density lipoprotein cholesterol accounted for 78.9% of variation in ox-Lp(a). CONCLUSIONS: Lp(a), ox-Lp(a) and Lp(a)-IC levels were increased in NS children, which may play an important role in the processes of atherosclerosis.

Measurement of oxidized lipoprotein (a) in patients with acute coronary syndromes and stable coronary artery disease by 2 ELISAs: using different capture antibody against oxidized lipoprotein (a) or oxidized LDL.

OBJECTIVE: To evaluate clinical value of oxidized lipoprotein(a) [ox-Lp(a)] levels. DESIGN AND METHODS: Ox-Lp(a) were measured by 2 ELISAs using antibodies against ox-Lp(a) [ox-Lp(a)1] or oxidized low-density lipoprotein [ox-Lp(a)2], and studied in 161 acute coronary syndromes (ACS) patients, 114 stable coronary artery disease (CAD) and 100 control subjects. RESULTS: Ox-Lp(a)1 was found related with ox-Lp(a)2 (r=0.864, P=0.000). Controlling for plasma lipids, Lp(a) and clinical characteristics, odds ratios of ox-Lp(a)1 on ACS and stable CAD were 5.06 (95% confidence interval 1.82-14.04) and 2.20 (0.78-6.22); those of ox-Lp(a)2 were 3.37 (1.07-10.63) and 1.35 (0.41-4.48), respectively. Receiver-operating characteristic curve analysis confirmed that performances of ox-Lp(a)1 were significantly superior to those for ox-Lp(a)2 in ACS (area: 0.803 vs. 0.723, P<0.001) and stable CAD (area: 0.670 vs. 0.607, P<0.01). CONCLUSION: Ox-Lp(a) levels using antibodies against ox-Lp(a) may represent a better risk marker than those using antibodies against oxidized low-density lipoprotein for ACS and stable CAD.

Percutaneous coronary intervention results in acute increases in native and oxidized lipoprotein(a) in patients with acute coronary syndrome and stable coronary artery disease.

OBJECTIVE: To investigate possible changes of native and oxidized lipoprotein(a) [ox-Lp(a)] levels after percutaneous coronary intervention (PCI). DESIGN AND METHODS: Lp(a), ox-Lp(a), and Lp(a) immune complexes (IC) and autoantibody levels were studied in 111 patients with acute coronary syndrome (ACS) and 68 patients with stable coronary artery disease (CAD) before and after PCI. RESULTS: Compared with pre-PCI, Lp(a), ox-Lp(a), and Lp(a)-IC levels acutely increased, while the autoantibody decreased in both the ACS and stable CAD patients. They all returned toward baseline by 1 to 2 days. The absolute change of ox-Lp(a) was found positively related with both the diameter of stenosis (R=0.273, P=0.004) and the number of vessel disease (R=0.312, P=0.001) in the ACS patients, while not in the stable CAD patients. CONCLUSION: PCI results in acute plasma increases of ox-Lp(a) and Lp(a). Ox-Lp(a) may be present in ruptured or permeable plaques and be released into the circulation by PCI.

Elevated concentrations of oxidized lipoprotein(a) are associated with the presence and severity of acute coronary syndromes.

OBJECTIVE: To investigate possible mechanisms and association of increased oxidized Lp(a) [ox-Lp(a)] levels with presence and extent of acute coronary syndromes (ACS). METHODS: Ox-Lp(a) levels were studied in 96 patients with ACS, 89 patients with stable coronary artery disease (CAD), and 100 control subjects. RESULTS: Compared to control, ox-Lp(a) levels increased in stable CAD patients (P<0.001), and especially in ACS (P<0.001) (ACS, 16.29+/-13.80 microg/ml; stable CAD, 10.04+/-10.32 microg/ml; control, 7.10+/-9.16 microg/ml). The ratio of ox-Lp(a) to Lp(a) was higher in the ACS than those in the stable CAD (P<0.05) and control (P<0.001). Ox-Lp(a) levels were found associated with a graded increase in extent of angiographically documented CAD in the ACS (R=0.275, P=0.007), while not in the stable CAD (R=0.090, P=0.402). Multiple linear regression analysis found ox-Lp(a) (beta=0.271, P=0.019), age (beta=0.244, P=0.038) and TG (beta=0.213, P=0.070) accounted for 11.1% of the variation in the extent of angiographically documented CAD in ACS patients; Lp(a) (beta=0.415, P=0.000) and extent of CAD (beta=0.193, P=0.071) accounted for 21.5% of that in ox-Lp(a) levels. CONCLUSION: Elevated ox-Lp(a) levels are associated with presence and severity of ACS, and may be useful for identification of patients with ACS.