Vaudo Gaetano, Marchesi Simona, Lupattelli Graziana, Pirro Matteo, Pasqualini Leonella, Roscini Anna Rita, Siepi Donatella, Schillaci Giuseppe, Mannarino Elmo
Department of Internal Medicine, Angiology, and Atherosclerosis, University of Perugia, Perugia, Italy.
Metabolism. 2003 Mar;52(3):328-32. doi: 10.1053/meta.2003.50070.
The relationship between hypoalphalipoproteinemia (hypoalpha), a metabolic disorder characterized by reduced high-density lipoprotein (HDL) cholesterol levels, and atherosclerotic disease is not completely understood. We investigated arterial functional and structural changes in 19 subjects with hypoalpha (HDL cholesterol < or = 0.7 mmol/L for men and < or = 0.8 mmol/L for women; 13 men; 47 +/- 7 years) and in 21 healthy control subjects (11 men; 46 +/- 13 years). Brachial-artery flow-mediated vasodilation (FMV) and intima-media thickness (IMT) of the carotid and femoral arteries were determined in all subjects. FMV was significantly lower in hypoalpha than in controls (5.6% +/- 4.3% v 8.2% +/- 2.7%; P <.05). IMT was greater in hypoalpha than in controls at both the internal carotid (0.83 +/- 0.1 mm v 0.69 +/- 0.1 mm) and superficial femoral level (0.83 +/- 0.2 mm v 0.68 +/- 0.1 mm; both P <.05). FMV had a positive correlation with HDL cholesterol (r =.42, P =.06) and a negative one with triglycerides (r = -0.38, P =.01). An inverse relationship was found between HDL cholesterol and internal carotid and superficial femoral IMT (r = -0.64 and r = -0.60, respectively; P <.01 for both) and a positive one between triglycerides and internal carotid and superficial femoral IMT (r =.53 and r =.47, P <.05). In a multivariate regression analysis, brachial FMV was predicted by HDL cholesterol and brachial diameter (beta =.42 and -0.43, respectively; both P <.05). HDL cholesterol was the only significant predictor of internal carotid and superficial femoral IMT (beta = -0.45 and -0.49, respectively; both P <.05). In conclusion, subjects with primary hypoalpha, without overt cardiovascular disease, are characterized by an impaired endothelial function and by an increase in large-artery IMT.
低α脂蛋白血症（低α）是一种以高密度脂蛋白（HDL）胆固醇水平降低为特征的代谢紊乱疾病，其与动脉粥样硬化疾病之间的关系尚未完全明确。我们对19名低α脂蛋白血症患者（男性HDL胆固醇≤0.7 mmol/L，女性≤0.8 mmol/L；13名男性；年龄47±7岁）和21名健康对照者（11名男性；年龄46±13岁）的动脉功能和结构变化进行了研究。测定了所有受试者肱动脉血流介导的血管舒张功能（FMV）以及颈动脉和股动脉的内膜中层厚度（IMT）。低α脂蛋白血症患者的FMV显著低于对照组（5.6%±4.3%对8.2%±2.7%；P<.05）。低α脂蛋白血症患者的颈内动脉（0.83±0.1 mm对0.69±0.1 mm）和股浅动脉水平（0.83±0.2 mm对0.68±0.1 mm）的IMT均大于对照组（均P<.05）。FMV与HDL胆固醇呈正相关（r=.42，P=.06），与甘油三酯呈负相关（r=-0.38，P=.01）。HDL胆固醇与颈内动脉和股浅动脉IMT呈负相关（分别为r=-0.64和r=-0.60；两者P<.01），甘油三酯与颈内动脉和股浅动脉IMT呈正相关（r=.53和r=.47，P<.05）。在多因素回归分析中，肱动脉FMV可由HDL胆固醇和肱动脉直径预测（β分别为.42和-0.43；两者P<.05）。HDL胆固醇是颈内动脉和股浅动脉IMT的唯一显著预测因子（β分别为-0.45和-0.49；两者P<.05）。总之，原发性低α脂蛋白血症且无明显心血管疾病的患者，其特征为内皮功能受损和大动脉IMT增加。
