Lobo R A, Notelovitz M, Bernstein L, Khan F Y, Ross R K, Paul W L
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, CA 90033.
Am J Obstet Gynecol. 1992 Apr;166(4):1182-8; discussion 1188-90.
Lp(a) lipoprotein is a distinct lipoprotein particle that recently has been found to be associated with cardiovascular disease. A study was conducted to assess the influence of cardiovascular disease risk factors on levels of Lp(a) and to evaluate the effects of age, exercise, and estrogen on these levels.
Two studies, a cross-sectional study of older men (n = 105) and women (n = 75) (mean age 76 years) and a prospective study of younger postmenopausal women (mean age 48 years), were carried out. Lp(a) and other lipoproteins were measured in the two studies and differences were sought by statistical analysis.
In the cross-sectional study, serum Lp(a) was similar in men and women and was not influenced by age. Lp(a) levels in men and women were higher when there was more than one cardiovascular disease risk factor present (p less than 0.028). We could not demonstrate such a relationship with other lipid and lipoprotein measurements. In the prospective study exercise alone had no influence on Lp(a) levels. Oral estrogen decreased Lp(a) levels marginally (p = 0.08). The decrease in Lp(a) with oral estrogen was associated with increases in triglycerides (p less than 0.01) and very-low-density lipoprotein (p less than 0.06).
These data confirm that elevated Lp(a) levels are an independent risk factor for cardiovascular disease. Lp(a) levels are primarily influenced by genetic factors and it appears estrogen may have a minor influence on its hepatic synthesis.
脂蛋白(a)[Lp(a)]是一种独特的脂蛋白颗粒，最近被发现与心血管疾病有关。本研究旨在评估心血管疾病危险因素对Lp(a)水平的影响，并评价年龄、运动和雌激素对这些水平的作用。
开展了两项研究，一项是对老年男性（n = 105）和女性（n = 75）（平均年龄76岁）的横断面研究，另一项是对年轻绝经后女性（平均年龄48岁）的前瞻性研究。在这两项研究中测量了Lp(a)和其他脂蛋白，并通过统计分析寻找差异。
在横断面研究中，男性和女性的血清Lp(a)相似，且不受年龄影响。当存在一种以上心血管疾病危险因素时，男性和女性的Lp(a)水平较高（p < 0.028）。我们未能证明与其他脂质和脂蛋白测量值存在这种关系。在前瞻性研究中，单独运动对Lp(a)水平没有影响。口服雌激素使Lp(a)水平略有下降（p = 0.08）。口服雌激素导致的Lp(a)下降与甘油三酯（p < 0.01）和极低密度脂蛋白（p < 0.06）升高有关。
这些数据证实Lp(a)水平升高是心血管疾病的独立危险因素。Lp(a)水平主要受遗传因素影响，雌激素似乎对其肝脏合成有轻微影响。
