Elmas Elif, Kälsch Thorsten, Suvajac Nenad, Leweling Hans, Neumaier Michael, Dempfle Carl-Erik, Borggrefe Martin
I. Department of Medicine, University Hospital of Mannheim, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Int J Cardiol. 2007 Jan 8;114(2):172-5. doi: 10.1016/j.ijcard.2006.01.011. Epub 2006 May 30.
High intake of saturated fat is a predictor of coronary heart disease mortality. The phenomenon of postprandial angina pectoris has been described many years ago. Although earlier studies have demonstrated postprandial activation of coagulation factors VII and XII, platelets and monocytes, conclusive evidence for intravascular fibrin formation after a fat-rich meal has not been reported yet. The present study included 33 healthy physicians (7 females, 26 males) with a mean age of 42 years (range 27-62 years), and 27 coronary heart disease patients (8 females, 19 males) with a mean age of 63 years (range 47-81 years). Of the coronary heart disease patients, 26/27 were treated with acetylsalicylic acid and 25/27 with lipid-lowering drugs simvastatin or atorvastatin. Blood samples were drawn 30-60 min before and 30-60 min after a dinner consisting of rye bread with liversausage and black pudding as hors d'oeuvre, lettuce with smoked bacon in a lard dressing, stuffed fried goose with red cabbage, potato dumplings and sweet chestnuts, and white and brown mousse au chocolat. Average intake per person was 3760 kcal, with 125.9 g protein, 238.0 g fat and 268.9 g carbohydrate. We measured a significant postprandial increase in fibrinopeptide A (FpA) levels from 1.14+/-1.23 microg/l to 4.18+/-2.86 microg/l (p<0.0001) in healthy probands, and 4.66+/-13.61 microg/l to 12.80+/-15.04 microg/l (p<0.0001) in coronary heart disease patients. Triglycerides increased from 137.6+/-60.5 to 201.5+/-75.0 mg/dl in healthy probands and from 211.9+/-94.6 to 273.6+/-122.5 mg/dl in coronary heart disease patients. Fat-rich meals may cause procoagulant episodes, which may promote vascular complications such as myocardial infarction, transient ischemia attacks in susceptible persons.
高饱和脂肪摄入量是冠心病死亡率的一个预测指标。餐后心绞痛现象早在多年前就有描述。尽管早期研究已证实餐后凝血因子VII和XII、血小板及单核细胞会被激活，但富含脂肪的餐后血管内纤维蛋白形成的确凿证据尚未见报道。本研究纳入了33名健康医生（7名女性，26名男性），平均年龄42岁（范围27 - 62岁），以及27名冠心病患者（8名女性，19名男性），平均年龄63岁（范围47 - 81岁）。在冠心病患者中，27人中有26人接受了乙酰水杨酸治疗，27人中有25人使用了降血脂药物辛伐他汀或阿托伐他汀。在一顿晚餐前后30 - 60分钟采集血样，晚餐包括黑麦面包配肝肠和黑布丁作为开胃菜、生菜配烟熏培根猪油酱、酿馅炸鹅配红甘蓝、土豆丸子和甜栗子，以及白色和棕色巧克力慕斯。人均摄入量为3760千卡，含125.9克蛋白质、238.0克脂肪和268.9克碳水化合物。我们检测到健康受试者餐后纤维蛋白肽A（FpA）水平显著升高，从1.14±1.23微克/升升至4.18±2.86微克/升（p<0.0001），冠心病患者从4.66±13.61微克/升升至12.80±15.04微克/升（p<0.0001）。健康受试者甘油三酯从137.6±60.5毫克/分升升至201.5±75.0毫克/分升，冠心病患者从211.9±94.6毫克/分升升至273.6±122.5毫克/分升。富含脂肪的膳食可能会引发促凝血发作，这可能会促使易感人群发生血管并发症，如心肌梗死、短暂性脑缺血发作。
