Lundman P, Eriksson M J, Stühlinger M, Cooke J P, Hamsten A, Tornvall P
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.
J Am Coll Cardiol. 2001 Jul;38(1):111-6. doi: 10.1016/s0735-1097(01)01318-3.
The aim of this study was to investigate endothelial function and common carotid intima-media thickness (IMT) in healthy young men with mild-to-moderate hypertriglyceridemia. Plasma asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, was measured to further elucidate the mechanisms involved.
Hypertriglyceridemia is a risk factor for coronary heart disease although the mechanisms behind the increased risk remain to be defined. Acute elevation of plasma triglycerides induced by an intravenous fat load is associated with impaired endothelial function. The results of studies examining acute effects induced by a high-fat meal or effects of chronic hypertriglyceridemia on endothelial function are more inconsistent.
Flow-mediated vasodilation and nitroglycerin-induced vasodilation of the brachial artery and common carotid IMT were measured noninvasively by ultrasound technique in 15 hypertriglyceridemic (HTG) subjects and 15 matched controls, mean age 34 years. Plasma concentrations of ADMA were measured by high-performance liquid chromatography.
Flow-mediated vasodilation was decreased in the HTG group (p < 0.0001), whereas nitroglycerin-induced vasodilation and carotid IMT did not differ significantly. Asymmetric dimethylarginine concentrations were higher in the HTG group (p < 0.05).
Hypertriglyceridemia in young men is associated with endothelial dysfunction and increased plasma concentration of ADMA but not with increased IMT of the common carotid artery. The corollary is that chronic hypertriglyceridemia results in endothelial dysfunction, possibly due to increased ADMA concentration, and that endothelial dysfunction might precede increased IMT among the early manifestations of atherosclerosis.
本研究旨在调查轻度至中度高甘油三酯血症的健康年轻男性的内皮功能和颈总动脉内膜中层厚度(IMT)。测量血浆不对称二甲基精氨酸(ADMA),一种内源性一氧化氮合酶抑制剂,以进一步阐明其中涉及的机制。
高甘油三酯血症是冠心病的一个危险因素,尽管风险增加背后的机制仍有待确定。静脉脂肪负荷引起的血浆甘油三酯急性升高与内皮功能受损有关。研究高脂肪餐引起的急性效应或慢性高甘油三酯血症对内皮功能影响的结果更不一致。
通过超声技术对15名高甘油三酯血症(HTG)受试者和15名匹配对照(平均年龄34岁)进行无创测量肱动脉的血流介导的血管舒张和硝酸甘油诱导的血管舒张以及颈总动脉IMT。通过高效液相色谱法测量血浆ADMA浓度。
HTG组的血流介导的血管舒张降低(p < 0.0001),而硝酸甘油诱导的血管舒张和颈动脉IMT无显著差异。HTG组的不对称二甲基精氨酸浓度较高(p < 0.05)。
年轻男性的高甘油三酯血症与内皮功能障碍和血浆ADMA浓度升高有关,但与颈总动脉IMT增加无关。由此推论,慢性高甘油三酯血症导致内皮功能障碍,可能是由于ADMA浓度增加,并且内皮功能障碍可能在动脉粥样硬化的早期表现中IMT增加之前出现。