Isser H S, Puri V K, Narain V S, Saran R K, Dwivedi S K, Singh S
Department of Cardiology, King George's Medical College, Lucknow.
Indian Heart J. 2001 Jul-Aug;53(4):463-6.
Studies among emigrant Indians have stressed the role of a powerful genetic factor, lipoprotein (a), in the causation of premature coronary artery disease. This study was carried out to assess lipoprotein (a) and lipid levels in 50 consecutive young north Indian patients (age less than 45 years, mean age 39+/-3.7 years) with myocardial infarction, their first-degree relatives (n=125, mean age 36+/-16 years), and age- and sex-matched controls (n=50, mean age 34+/-6.9 years).
Blood samples for lipid estimation were taken within 24 hours of myocardial infarction and after overnight fasting for twelve hours. Lipoprotein (a) levels were estimated by the ELISA technique using preformed antibodies while lipid levels were estimated by kits using the colorimetric method. All were male patients. The mean lipoprotein (a) level was 22.28+5.4 mg/dl in patients, 13.88+5.19 mg/dl in their first-degree relatives and 9.28+22.59 mg/dl in controls. In addition, it was significantly higher in young patients with myocardial infarction and their relatives as compared to controls (p<0.001 for patients v. controls and p<0.05 for relatives v. controls). There was no significant difference in the levels of total cholesterol and low-density lipoprotein cholesterol among the three groups. High-density lipoprotein cholesterol was significantly lower in young patients with myocardial infarction (30.16+/-9.45 mg/dl) and their first-degree relatives (33.28+/-8.45 mg/dl) as compared to controls (46.8+/-8.04 mg/dl) (p<0.001 for patients v. controls and p<0.01 for relatives v. controls). Triglyceride levels were significantly higher in patients as compared to controls (202+/-76 mg/dl v. 149 + 82.99 mg/dl, p<0.05). Smoking was more prevalent in young patients with myocardial infarction as compared to controls (44% v. 36%, p<0.05).
Smoking, high lipoprotein (a) and triglyceride levels and low high-density lipoprotein levels may be important risk factors for coronary artery disease in the younger population; also, there is familial clustering of high lipoprotein (a) levels in first-degree relatives of young patients with myocardial infarction.
对移民印度人的研究强调了一种强大的遗传因素，即脂蛋白(a)，在早发性冠状动脉疾病病因中的作用。本研究旨在评估50例连续的年轻北印度心肌梗死患者（年龄小于45岁，平均年龄39±3.7岁）、他们的一级亲属（n = 125，平均年龄36±16岁）以及年龄和性别匹配的对照组（n = 50，平均年龄34±6.9岁）的脂蛋白(a)和血脂水平。
在心肌梗死后24小时内及禁食12小时过夜后采集血样进行血脂测定。脂蛋白(a)水平采用酶联免疫吸附测定（ELISA）技术，使用预制抗体进行检测，而血脂水平则使用试剂盒通过比色法进行检测。所有患者均为男性。患者的平均脂蛋白(a)水平为22.28 + 5.4mg/dl，其一级亲属为13.88 + 5.19mg/dl，对照组为9.28 + 22.59mg/dl。此外，与对照组相比，年轻心肌梗死患者及其亲属的脂蛋白(a)水平显著更高（患者与对照组相比p < 0.001，亲属与对照组相比p < 0.05）。三组之间的总胆固醇和低密度脂蛋白胆固醇水平无显著差异。与对照组（46.8±8.04mg/dl）相比，年轻心肌梗死患者（30.16±9.45mg/dl）及其一级亲属（33.28±8.45mg/dl）的高密度脂蛋白胆固醇显著更低（患者与对照组相比p < 0.001，亲属与对照组相比p < 0.01）。与对照组相比，患者的甘油三酯水平显著更高（202±76mg/dl对149 + 82.99mg/dl，p < 0.05）。与对照组相比，年轻心肌梗死患者吸烟更为普遍（44%对36%，p < 0.05）。
吸烟、高脂蛋白(a)和甘油三酯水平以及低高密度脂蛋白水平可能是年轻人群冠状动脉疾病的重要危险因素；此外，年轻心肌梗死患者的一级亲属中脂蛋白(a)水平存在家族聚集现象。
