冠心病中的脂蛋白(a)：一项病例对照研究。

Lipoprotein(a) in coronary heart disease: a case-control study.

作者信息

Gupta R, Kastia S, Rastogi S, Kaul V, Nagar R, Enas E A

机构信息

Department of Medicine, Monilek Hospital, Jaipur.

出版信息

Indian Heart J. 2000 Jul-Aug;52(4):407-10.

PMID:11084780

Abstract

To determine the significance of lipoprotein(a) levels in coronary heart disease patients, a case-control study was performed with 48 newly diagnosed coronary heart disease patients and 23 controls who were evaluated using clinical history and biochemical examination. Lipoprotein(a) was measured by quantitative latex-enhanced immunoturbidimetric method. Geometric means of biochemical parameters were obtained. Comprehensive lipid tetrad index was calculated using a previously validated formula. There was no significant difference in prevalence of diabetes, hypertension and smoking in cases and controls. Dietary intake of calories, fats, fatty acids and antioxidant vitamins was also similar. The levels of fasting glucose, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides were not significantly different in cases and controls (p > 0.05). Low-density lipoprotein/high-density lipoprotein ratio (4.33 +/- 1.5 vs 4.29 +/- 1.8) and total cholesterol/high-density lipoprotein ratio (6.59 + 1.7 vs 6.69 +/- 2.2) were similar. The mean lipoprotein(a) levels were significantly greater in cases (11.95 +/- 2.8 mg/dL, range 1-102 mg/dL) as compared to controls (6.68 +/- 3.4 mg/dL, range 1-73 mg/dL) (t = 2.08, p = 0.041). As compared to controls, in coronary heart disease cases, mean lipoprotein(a) levels in patients upto 50 years (10.27 +/- 2.8 vs 7.27 +/- 3.4 mg/dL) as well as those over 50 years (12.99 +/- 2.9 vs 4.91 +/- 3.5 mg/dL) were significantly more (p < 0.05). Coronary heart disease patients had a slightly greater prevalence of high lipoprotein(a) levels, 20 mg/dL or more (31.3 vs 13.0%; chi 2 = 2.83, l-tailed p < 0.05). Comprehensive lipid tetrad index (total cholesterol x triglycerides x lipoprotein(a) divided by high-density lipoprotein cholesterol) was also slightly higher in cases (14688.2 +/- 3.6) than in controls (8358.2 +/- 4.3) (t = 1.68, 1-tailed p < 0.05). This study shows that lipoprotein(a) levels are significantly more in both younger and older coronary heart disease patients as compared to controls.

摘要

为了确定脂蛋白(a)水平在冠心病患者中的意义，进行了一项病例对照研究，研究对象为48例新诊断的冠心病患者和23名对照者，通过临床病史和生化检查对他们进行评估。脂蛋白(a)采用定量乳胶增强免疫比浊法测定。获得生化参数的几何均值。使用先前验证的公式计算综合脂质四分位数指数。病例组和对照组在糖尿病、高血压和吸烟的患病率方面没有显著差异。热量、脂肪、脂肪酸和抗氧化维生素的饮食摄入量也相似。病例组和对照组的空腹血糖、胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯水平没有显著差异(p>0.05)。低密度脂蛋白/高密度脂蛋白比值(4.33±1.5对4.29±1.8)和总胆固醇/高密度脂蛋白比值(6.59 + 1.7对6.69±2.2)相似。与对照组相比，病例组的平均脂蛋白(a)水平显著更高(11.95±2.8mg/dL，范围1 - 102mg/dL)，而对照组为(6.68±3.4mg/dL，范围1 - 73mg/dL)(t = 2.08，p = 0.041)。与对照组相比，在冠心病病例中，50岁及以下患者的平均脂蛋白(a)水平(10.27±2.8对7.27±3.4mg/dL)以及50岁以上患者的平均脂蛋白(a)水平(12.99±2.9对4.91±3.5mg/dL)均显著更高(p<0.05)。冠心病患者中脂蛋白(a)水平高于20mg/dL的患病率略高(31.3%对13.0%；卡方=2.83，单侧p<0.05)。病例组的综合脂质四分位数指数(总胆固醇×甘油三酯×脂蛋白(a)除以高密度脂蛋白胆固醇)也略高于对照组(14688.2±3.6)对(8358.2±4.3)(t = 1.68，单侧p<0.05)。这项研究表明，与对照组相比，年轻和老年冠心病患者的脂蛋白(a)水平均显著更高。