Rizzo M, Barbagallo C M, Severino M, Polizzi F, Onorato F, Noto D, Cefalù A B, Pace A, Marino G, Notarbartolo A, Averna R M
Department of Clinical Medicine, University of Palermo, Palermo, Italy.
Eur J Clin Invest. 2003 Feb;33(2):126-33. doi: 10.1046/j.1365-2362.2003.01125.x.
The predominance of small, dense low-density lipoprotein (LDL) particles ('LDL phenotype B') has been associated with a three-fold increased risk of myocardial infarction, but the feasibility of the identification of small, dense LDL as independent predictors of coronary artery disease risk in population studies remains questioned. Design We evaluated the LDL peak particle size and its relation with other established risk factors for coronary heart disease in a group of 156 randomized subjects living on the Mediterranean island of Ustica (71 males and 85 women, range of age 20-69 years), representing approximately 30% of the total population.
The prevalence of LDL phenotype B subjects was low (approximately 15% in both men and women) and there was a clear trend for both genders in reducing the LDL peak particle size with age. Moreover, LDL phenotype B subjects had higher BMI values, prevalence of diabetes and plasma triglyceride (TG) levels and lower plasma HDL-C concentrations in comparison with LDL phenotype A individuals; in a multivariate analysis, plasma TG levels were the only variable independently associated with LDL peak particle size.
In this population, which appears to be somewhat protected by premature coronary artery disease, a low prevalence of the LDL pattern B was found in both men and women, and plasma TG could have a key role in regulating the LDL peak particle size. The follow up, still ongoing, will provide useful information on the predictive role of LDL peak particle size on cardiovascular risk, at least in a low-risk population.
小而密的低密度脂蛋白（LDL）颗粒（“LDL表型B”）占优势与心肌梗死风险增加三倍相关，但在人群研究中，将小而密的LDL识别为冠状动脉疾病风险独立预测指标的可行性仍受到质疑。设计：我们评估了地中海乌斯蒂卡岛上156名随机受试者（71名男性和85名女性，年龄范围20 - 69岁）的LDL峰值粒径及其与其他已确立的冠心病危险因素的关系，这些受试者约占总人口的30%。
LDL表型B受试者的患病率较低（男性和女性均约为15%），且男女两性均有随着年龄增长LDL峰值粒径减小的明显趋势。此外，与LDL表型A个体相比，LDL表型B受试者的BMI值、糖尿病患病率和血浆甘油三酯（TG）水平更高，血浆高密度脂蛋白胆固醇（HDL - C）浓度更低；在多变量分析中，血浆TG水平是唯一与LDL峰值粒径独立相关的变量。
在这个似乎在一定程度上受到早发冠状动脉疾病保护的人群中，发现男性和女性的LDL模式B患病率均较低，血浆TG可能在调节LDL峰值粒径方面起关键作用。仍在进行的随访将至少在低风险人群中提供关于LDL峰值粒径对心血管风险预测作用的有用信息。
