Obesity, which means the excess adipose tissue has accumulated in the body, is a well-recognized strong risk factor for the occurrence and development of PCAD ( 6– 8). PCAD is a complex multifactorial disease and its underlying mechanisms are still remaining unclear. For this reason, there is necessary to identify novel and reliable biomarkers that could help to diagnose PCAD patients in its early phases. However, it still remains a challenge to identify patients with PCAD early because the coronary angiography is the gold standard diagnostics for PCAD and it is much more complex and expensive ( 5). Patients with PCAD need much more attention since its devastating effect on individuals, families and the society. Premature coronary artery disease (PCAD), which is defined as the presence of any coronary artery stenosis ≥50% in males aged <55 years or females aged <65 years, has become more prevalent in recent years ( 4). It is estimated that approximately 4–10% of patients with documented CAD are <45 years ( 2, 3). However, with the rapid development of the economy and the change of lifestyle, CAD is often encountered by young adults nowadays. In the past, studies about CAD usually concentrated on the old population. Furthermore, CAD accounts for about one-third of all deaths in adults aged over 35 years in the United States ( 1). According to the 2017 updated Heart Disease and Stroke statistics from the American Heart Association, 16.5 million persons aged ≥20 years in the United States have CAD ( 1). ZAG might be the potential diagnostic biomarkers for PCAD patients, and the combination of ZAG and clinical variables had higher discriminative performance.Ĭoronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. Subjects with lower ZAG levels were more likely to have PCAD, especially for male subjects with BMI <24 kg/m 2. The combination of ZAG with other clinical variables including age, gender, BMI, SBP, FBG, TC, HDL-C, Cr, and Urea had significantly improved the diagnosis accuracy with a sensitivity of 82.6%, a specificity of 95.0%, and AUC of 0.957 (95% CI, 0.940–0.975, p < 0.05).Ĭonclusion: Serum ZAG levels were firstly found to be decreased in Chinese PCAD patients. At the cutoff value of 7.955 μg/mL serum ZAG, the sensitivity and specificity for differentiating patients with PCAD from controls were 50.5 and 78.0%, respectively. The receiver operating curve (ROC) analysis showed a weak diagnostic performance of serum ZAG for PCAD (AUC = 0.659, 95% CI 0.612–0.705, p < 0.05). This phenomenon was more likely to be observed in male subjects with BMI <24 kg/m 2. The probability of PCAD in subjects with low tertile ZAG levels was 2.48-fold higher than those with high tertile levels after adjusting for other confounders. Multiple regression analysis showed that PCAD was independently associated with serum ZAG levels ( B = −0.289, p = 0.002). 8.78 ± 1.89 μg/mL, p < 0.05), respectively, when compared with the controls. Results: Serum ZAG were significantly lower in the PCAD (8.03 ± 1.01 vs. Serum ZAG levels were determined by enzyme-linked immunosorbent assay (ELISA) method. In addition, 182 age and gender matched healthy controls were also enrolled. According to the degree of coronary artery stenosis, the number of 364 patients with PCAD (age <55 years in males and <65 years in females) and 126 age and gender matched patients without premature coronary artery disease (NPCAD) were recruited in our present study. Methods: A total of 3,364 patients who were undergone coronary angiography in Peking Union Medical College Hospital were screened. Objectives: To explore serum zinc-α2-glycoprotein (ZAG) changes in patients with or without premature coronary artery disease (PCAD) and its association with several cardiovascular risk factors. 2Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.1Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.Meijuan Liu 1 †, Huijuan Zhu 1 †, Tianshu Zhai 1, Hui Pan 1, Linjie Wang 1, Hongbo Yang 1, Kemin Yan 1, Yong Zeng 2 and Fengying Gong 1 *