Wittenstein Birgit, Klein Marcus, Finckh Barbara, Ullrich Kurt, Kohlschütter Alfried
Department of Paediatrics, University Hospital Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
Eur J Pediatr. 2002 Oct;161 Suppl 1:S70-4. doi: 10.1007/s00431-002-1008-7. Epub 2002 Sep 19.
Oxidative mechanisms involving lipid peroxidation in the subendothelium of the arterial vessel wall play a key role in atherogenesis. Despite severe hyperlipidaemia, patients with glycogen storage disease type 1a (GSD1a) do not develop premature atherosclerosis. Therefore, we analysed parameters of antioxidative defence and oxidative stress in plasma and serum of patients with GSD1a ( n=17) and compared them with those of patients with type 1 diabetes mellitus ( n=17), familial hypercholesterolaemia ( n=18) and healthy controls ( n=20). We measured the total radical trapping ability parameter (TRAP), single plasma antioxidants (sulfhydryl-groups, uric acid, vitamin C, alpha-tocopherol, coenzyme-Q10), markers of lipid peroxidation, lipoprotein (a) and homocysteine. Patients with GSD1a showed an elevated TRAP ( P<0.01) compared to the three other groups. This can mainly be attributed to elevated uric acid levels ( P<0.05 versus control). Lipoprotein (a) was significantly lower in the GSD1a group compared to the three other groups ( P<0.05).
Patients with glycogen storage disease type 1a show an increased antioxidative defence in plasma which may protect them against lipid peroxidation and thus against premature atherosclerosis. Our finding of low lipoprotein(a) levels in this small group of patients warrants further investigation in a greater number of patients before assessing its role in atherogenesis in glycogen storage disease type 1a.
动脉血管壁内皮下涉及脂质过氧化的氧化机制在动脉粥样硬化形成中起关键作用。尽管患有严重的高脂血症,但1a型糖原贮积病(GSD1a)患者并未发生过早的动脉粥样硬化。因此,我们分析了GSD1a患者(n = 17)血浆和血清中的抗氧化防御和氧化应激参数,并将其与1型糖尿病患者(n = 17)、家族性高胆固醇血症患者(n = 18)和健康对照者(n = 20)的参数进行比较。我们测量了总自由基捕获能力参数(TRAP)、单一血浆抗氧化剂(巯基、尿酸、维生素C、α-生育酚、辅酶Q10)、脂质过氧化标志物、脂蛋白(a)和同型半胱氨酸。与其他三组相比,GSD1a患者的TRAP升高(P < 0.01)。这主要可归因于尿酸水平升高(与对照组相比,P < 0.05)。与其他三组相比,GSD1a组的脂蛋白(a)显著降低(P < 0.05)。
1a型糖原贮积病患者血浆中的抗氧化防御增强,这可能保护他们免受脂质过氧化,从而预防过早的动脉粥样硬化。在评估其在1a型糖原贮积病动脉粥样硬化形成中的作用之前,我们在这一小群患者中发现的低脂蛋白(a)水平值得在更多患者中进一步研究。