Barbagallo Carlo M, Rizzo Manfredi, Noto Davide, Frasheri Arian, Pernice Vincenzo, Rubino Antonio, Pieri Daniele, Pinto Vito, Cefalù Angelo B, Giordano Carla, Notarbartolo Alberto, Averna Maurizio R
Department of Internal Medicine, Faculty of Medicine, University of Palermo, and Intensive Care Unit, Villa Maria Eleonora Hospital, Palermo, Italy.
Metabolism. 2006 May;55(5):662-8. doi: 10.1016/j.metabol.2006.01.005.
Triglycerides (TGs) are vehicled by multiple particles with different abilities to promote atherosclerosis. Among plasma TG-rich lipoproteins (TRLs), subspecies may or may not contain apolipoprotein E (apoE) molecules: in this study, we evaluated the relative contribution of apoE-rich and apoE-poor TRLs to coronary atherosclerosis. We selected a group of males with premature coronary artery disease (CAD) without any of the classical nonlipid risk factors and/or high plasma lipid levels and evaluated the plasma concentration of TRL subspecies in comparison with healthy controls. Patients with CAD and controls had total cholesterol and TG levels within the normal range (despite slightly, even if significantly, higher TG levels in patients with CAD) and low-density lipoprotein cholesterol levels near optimal values. Nevertheless, patients with CAD had significantly lower high-density lipoprotein cholesterol, smaller low-density lipoprotein peak particle size, and a reduced HDL2b subfraction than controls. In addition, we observed higher concentrations of total TRL in patients with CAD together with a selective increase in apoE-rich particles. All these data were confirmed after correction for TG levels. We also investigated which parameters were associated with the spread of coronary atherosclerosis. Subjects with a single-vessel disease had selectively lower levels of apoE-rich fractions than patients with a multivessel disease. This was confirmed by multivariate analysis. Patients with a premature CAD free of nonlipid conventional risk factors, despite not having elevated lipid levels, show several lipoprotein abnormalities. Besides known atherogenic alterations, the accumulation of apoE-rich TRL subfractions may represent an additive factor that can potentially promote and initiate the atherosclerotic process.
甘油三酯（TGs）由多种具有不同促进动脉粥样硬化能力的颗粒运载。在富含血浆甘油三酯的脂蛋白（TRLs）中，亚类可能含有或不含有载脂蛋白E（apoE）分子：在本研究中，我们评估了富含apoE和缺乏apoE的TRLs对冠状动脉粥样硬化的相对贡献。我们选择了一组患有早发性冠状动脉疾病（CAD）且无任何经典非脂质危险因素和/或高血浆脂质水平的男性，并与健康对照相比评估了TRL亚类的血浆浓度。CAD患者和对照组的总胆固醇和TG水平在正常范围内（尽管CAD患者的TG水平略高，即使有显著差异），低密度脂蛋白胆固醇水平接近最佳值。然而，CAD患者的高密度脂蛋白胆固醇显著降低，低密度脂蛋白峰值颗粒尺寸较小，且HDL2b亚组分比对照组减少。此外，我们观察到CAD患者的总TRL浓度较高，同时富含apoE的颗粒选择性增加。校正TG水平后，所有这些数据均得到证实。我们还研究了哪些参数与冠状动脉粥样硬化的扩展相关。单支血管疾病患者的富含apoE的组分水平比多支血管疾病患者选择性降低。多变量分析证实了这一点。无传统非脂质危险因素的早发性CAD患者，尽管脂质水平未升高，但仍表现出几种脂蛋白异常。除了已知的致动脉粥样硬化改变外，富含apoE的TRL亚组分的积累可能是一个潜在促进和启动动脉粥样硬化过程的附加因素。
