Tavridou A, Unwin N, Bhopal R, Laker M F
Department of Pharmacology, ELPEN Pharmaceutical Co. Inc., Pikermi, Attika, Greece.
Eur J Clin Invest. 2003 Aug;33(8):686-92. doi: 10.1046/j.1365-2362.2003.01201.x.
Understanding of the higher susceptibility of South Asians to coronary heart disease is limited. One explanation is the combination of high prevalence of insulin resistance with higher lipoprotein(a) levels.
Lipoprotein(a) levels and genotypes in three South Asian groups aged 25-74 years (Indian, Pakistani, Bangladeshi) were compared with a European population in a cross-sectional study. Biochemical measurements included lipids, apolipoprotein A1 and B, glucose, insulin and fibrinogen. Insulin sensitivity was calculated using the homoeostasis model assessment method (HOMA).
There was no significant difference in lipoprotein(a) levels between South Asian and European men. South Asian women combined had higher lipoprotein(a) levels than European women, a difference probably resulting from higher lipoprotein(a) levels in Pakistani women compared with Indian and Bangladeshi women. Fasting insulin and HOMA were negatively associated with Lp(a) in South Asians though the associations were statistically significant only in men. There were only modest associations between most cardiovascular risk factors and Lp(a). Twenty-seven apolipoprotein(a) size alleles were detected in the three South Asian groups ranging from 16 to 43 kringle-IV repeats. The apolipoprotein(a) size polymorphism explained 23% of the variability in lipoprotein(a) levels in South Asians.
There were few nongenetic predictors of lipoprotein(a) levels in South Asians and Europeans. The lack of difference in Lp(a) between the South Asian and European men and the fact that differences between the women seemed to be confined to the Pakistani group offer little support to the hypothesis that higher Lp(a) levels contribute to the increased risk of heart disease in South Asians. Our findings do not support the hypothesis that susceptibility to heart disease in South Asians results from a combination of high insulin resistance and high Lp(a) levels.
对南亚人冠心病易感性较高的了解有限。一种解释是胰岛素抵抗高患病率与较高的脂蛋白(a)水平相结合。
在一项横断面研究中，比较了三个年龄在25至74岁的南亚群体（印度人、巴基斯坦人、孟加拉国人）的脂蛋白(a)水平和基因型与欧洲人群。生化测量包括血脂、载脂蛋白A1和B、血糖、胰岛素和纤维蛋白原。使用稳态模型评估方法（HOMA）计算胰岛素敏感性。
南亚男性和欧洲男性的脂蛋白(a)水平无显著差异。南亚女性总体上脂蛋白(a)水平高于欧洲女性，这一差异可能是由于巴基斯坦女性的脂蛋白(a)水平高于印度和孟加拉国女性。空腹胰岛素和HOMA与南亚人的Lp(a)呈负相关，尽管这种关联仅在男性中具有统计学意义。大多数心血管危险因素与Lp(a)之间只有适度的关联。在三个南亚群体中检测到27个载脂蛋白(a)大小等位基因，范围从16到43个kringle-IV重复序列。载脂蛋白(a)大小多态性解释了南亚人脂蛋白(a)水平变异的23%。
南亚人和欧洲人中脂蛋白(a)水平的非遗传预测因素很少。南亚男性和欧洲男性的Lp(a)缺乏差异，以及女性之间的差异似乎仅限于巴基斯坦群体这一事实，几乎没有支持较高的Lp(a)水平导致南亚人心脏病风险增加这一假设。我们的研究结果不支持南亚人心脏病易感性源于高胰岛素抵抗和高Lp(a)水平相结合的假设。
