Totsuka M, Miyashita Y, Ito Y, Watanabe H, Murano T, Shirai K
Department of Internal Medicine, Sakura Hospital, School of Medicine, Toho University, 564-1, Shimoshizu, Sakura-shi, 285-8741, Chiba, Japan.
Atherosclerosis. 2000 Nov;153(1):175-9. doi: 10.1016/s0021-9150(00)00394-4.
To clarify the clinical implication of preheparin serum lipoprotein lipase mass (preheparin LpL mass), we studied the relationships between preheparin LpL mass and serum lipids, including midband lipoproteins, which migrate between very low density lipoproteins and low density lipoproteins on polyacrylamide gel disc electrophoresis, in hyperlipidemias. And we also studied the changes of preheparin LpL mass in hypertriglyceridemic patients during bezafibrate administration, which is known to enhance LpL activity in postheparin plasma. Preheparin LpL mass correlated positively with high-density lipoprotein-cholesterol (HDL-C) (r=0.418, P<0.01) and negatively with triglyceride (TG) (r=-0.256, P<0.01), but did not correlate with total cholesterol (TC) in 64 hyperlipidemic (type IIa, IIb and IV) patients. The midband lipoproteins were observed in 80% of hypertriglyceridemic patients (32/40). Preheparin LpL mass in midband lipoprotein-positive subjects was lower significantly than that in midband-negative subjects. When bezafibrate (400 mg/day) was administrated to 40 hypertriglyceridemic patients for 4 months, TG level significantly decreased (-49+/-7%, P<0.01), TC levels decreased (-11+/-4%, not significant), and HDL-C levels increased (+27+/-4%, P<0.01). The midband lipoproteins disappeared in 95% of patients. Preheparin LpL mass significantly increased (+25+/-6%, P<0. 0005). In nine patients who stopped bezafibrate, TG levels significantly increased (+49+/-7%, P<0.01) and HDL-C levels decreased (-27+/-4%, P<0.01). Preheparin LPL mass significantly decreased (-25+/-6%, P<0.0005). These results suggested that bezafibrate administration enhanced preheparin LpL mass. And it might be implicated that enhanced LpL production by bezafibrate could reflect an increase of preheparin LpL mass.
为阐明肝素前血清脂蛋白脂肪酶质量（肝素前LpL质量）的临床意义，我们研究了高脂血症患者中肝素前LpL质量与血清脂质（包括中带脂蛋白，其在聚丙烯酰胺凝胶圆盘电泳中迁移于极低密度脂蛋白和低密度脂蛋白之间）之间的关系。并且我们还研究了高甘油三酯血症患者在服用苯扎贝特期间肝素前LpL质量的变化，已知苯扎贝特可增强肝素后血浆中的LpL活性。在64例高脂血症（IIa型、IIb型和IV型）患者中，肝素前LpL质量与高密度脂蛋白胆固醇（HDL-C）呈正相关（r = 0.418，P < 0.01），与甘油三酯（TG）呈负相关（r = -0.256，P < 0.01），但与总胆固醇（TC）无相关性。在80%的高甘油三酯血症患者（32/40）中观察到了中带脂蛋白。中带脂蛋白阳性受试者的肝素前LpL质量显著低于中带脂蛋白阴性受试者。当对40例高甘油三酯血症患者给予苯扎贝特（400 mg/天）治疗4个月时，TG水平显著降低（-49±7%，P < 0.01），TC水平降低（-11±4%，无显著性差异），HDL-C水平升高（+27±4%，P < 0.01）。95%的患者中带脂蛋白消失。肝素前LpL质量显著增加（+25±6%，P < 0.0005）。在9例停用苯扎贝特的患者中，TG水平显著升高（+49±7%，P < 0.01），HDL-C水平降低（-27±4%，P < 0.01）。肝素前LPL质量显著降低（-25±6%，P < 0.0005）。这些结果表明，服用苯扎贝特可提高肝素前LpL质量。并且可能意味着苯扎贝特增强的LpL生成可反映肝素前LpL质量的增加。
