Cabezas Castro M, Liem A
Universitair Medisch Centrum, afd. Vasculaire Geneeskunde, Postbus 85.500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2003 Jul 26;147(30):1445-8.
Atherosclerosis is a multifactorial disorder in which lipid profiles play an important role. In addition to the conventional lipid parameters such as total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, there is an increasing interest in plasma apolipoprotein B (apoB) for risk stratification in daily practice. ApoB is the structural protein of all atherogenic lipoproteins. Each of these lipoproteins contains one apoB molecule and therefore the apoB concentration is a direct reflection of the number of atherogenic particles in the blood. Some patients have a reasonably normal lipid spectrum but an elevated concentration of apoB, which is associated with an increased risk for atherosclerotic complications. This is especially the case for patients with atherogenic forms of hypertriglyceridaemia and with insulin resistance syndrome. On the basis of epidemiological data, it appears that apoB not only has added value as a risk parameter but also as a treatment target. However the clinical use of apoB levels requires a standardised method with better-defined reference values, as is already the case for total-cholesterol and LDL-cholesterol levels.
动脉粥样硬化是一种多因素疾病，其中血脂谱起着重要作用。除了传统的血脂参数，如总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯外，血浆载脂蛋白B（apoB）在日常实践中的风险分层方面也越来越受到关注。apoB是所有致动脉粥样硬化脂蛋白的结构蛋白。这些脂蛋白中的每一种都含有一个apoB分子，因此apoB浓度直接反映了血液中致动脉粥样硬化颗粒的数量。一些患者的血脂谱相当正常，但apoB浓度升高，这与动脉粥样硬化并发症风险增加有关。对于致动脉粥样硬化型高甘油三酯血症患者和胰岛素抵抗综合征患者尤其如此。根据流行病学数据，似乎apoB不仅作为风险参数具有附加价值，而且作为治疗靶点也具有附加价值。然而，apoB水平的临床应用需要一种具有更明确参考值的标准化方法，总胆固醇和低密度脂蛋白胆固醇水平已经是这种情况。
