de Man F H, Nieuwland R, van der Laarse A, Romijn F, Smelt A H, Gevers Leuven J A, Sturk A
Department of Cardiology, C5-P, Leiden University Medical Centre, P. O. Box 9600, 2300 RC, Leiden, The Netherlands.
Atherosclerosis. 2000 Oct;152(2):407-14. doi: 10.1016/s0021-9150(99)00485-2.
Hypertriglyceridemia, a risk factor for cardiovascular disease, has been associated with hypercoagulability, but whether platelet activation is implicated is unknown. This study was designed to compare the in vivo platelet activation status between patients with severe hypertriglyceridemia and age- and sex-matched control subjects, and to evaluate the effects of triglyceride-lowering therapy. Sixteen patients with primary hypertriglyceridemia were included in a double-blind, placebo-controlled cross-over trial with 400 mg bezafibrate once daily. Platelet activation was analysed by double label flow cytometry, using monoclonal antibodies against GP53, P-selectin, and platelet-bound fibrinogen. Surface expression of the lysosomal membrane protein GP53 was significantly higher in the hypertriglyceridemic patients at baseline as compared to the group of age- and sex-matched controls (16.3+/-4.8% vs. 8.9+/-3.4%, respectively, P<0.001). No differences in the expression of P-selectin and fibrinogen binding were observed. In response to bezafibrate therapy, the expression of GP53 in the patient group decreased from 16.3+/-4.8% to 13.1+/-4.1% (P=0.018). The expression of P-selectin and fibrinogen binding was not affected by bezafibrate therapy. In conclusion, patients with hypertriglyceridemia have an increased in vivo platelet activation status, which can be improved by bezafibrate therapy.
高甘油三酯血症是心血管疾病的一个危险因素，与血液高凝性有关，但血小板激活是否与之相关尚不清楚。本研究旨在比较重度高甘油三酯血症患者与年龄和性别匹配的对照受试者的体内血小板激活状态，并评估降甘油三酯治疗的效果。16例原发性高甘油三酯血症患者纳入一项双盲、安慰剂对照的交叉试验，每天服用400mg苯扎贝特。采用抗GP53、P-选择素和血小板结合纤维蛋白原的单克隆抗体，通过双标记流式细胞术分析血小板激活情况。与年龄和性别匹配的对照组相比，高甘油三酯血症患者基线时溶酶体膜蛋白GP53的表面表达显著更高（分别为16.3±4.8%和8.9±3.4%，P<0.001）。未观察到P-选择素表达和纤维蛋白原结合的差异。在接受苯扎贝特治疗后，患者组中GP53的表达从16.3±4.8%降至13.1±4.1%（P=0.018）。苯扎贝特治疗未影响P-选择素表达和纤维蛋白原结合。总之，高甘油三酯血症患者的体内血小板激活状态增加，苯扎贝特治疗可改善这一状态。
