Moon Jae-Youn, Kwon Hyuck Moon, Kwon Sung Woo, Yoon Se-Jung, Kim Jung-Sun, Lee Sung-Ju, Park Jong Kwan, Rhee Ji-Hyuck, Yoon Young Won, Hong Bum-Kee, Rim Se-Joong, Kim Hyun Seung
Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Cardiology. 2007;108(4):282-9. doi: 10.1159/000099097. Epub 2007 Feb 8.
The pathophysiological role and metabolic pathway of Lp(a) have not been clearly defined. An association between Lp(a) and oxidative low-density lipoprotein (LDL) were recently reported. And small dense LDL (sd-LDL) were associated with circulating malondialdehyde-modified LDL. We investigated the relationships between serum Lp(a) level and LDL particle size in coronary artery disease (CAD) patients. Further, we investigated the relationships of sd-LDL and Lp(a) with the extent and severity of CAD.
A total of 490 patients (mean: 60.5 +/- 11.5 years old) who underwent coronary angiography to evaluate chest pain were investigated. Patients were classified into two groups, a CAD group (n = 256), who had significant stenosis observed by coronary angiogram, and a control group (n = 234), who had normal, or minimal coronary arteries. CAD severity was measured by Gensini scores. The distribution of the LDL subfraction was analyzed using a Quantimetrix Lipoprint LDL System.
The serum Lp(a) concentration was correlated with the fraction of sd-LDL (r = 0.193, p < 0.001) and mean LDL size (r = 0.160, p = 0.003). The Lp(a) level and mean LDL particle size were significantly correlated with a high Gensini score. LDL particle size in the CAD group was smaller than in the control group (26.74 +/- 0.64 vs. 26.43 +/- 0.93 nm, p < 0.001). The Gensini score was significantly higher in small LDL with high Lp(a) level groups.
The positive correlation of the level of Lp(a) and sd-LDL fraction were demonstrated. The mechanism of this association is not clearly defined; we can suggest that it may stem from the individual atherogenic condition that linked to increased oxidative stress. Both increased Lp(a) and sd-LDL fraction were correlated with the severity of CAD.
脂蛋白(a)[Lp(a)]的病理生理作用及代谢途径尚未明确。最近有报道称Lp(a)与氧化型低密度脂蛋白(LDL)之间存在关联。而小而密低密度脂蛋白(sd-LDL)与循环中的丙二醛修饰的LDL有关。我们研究了冠状动脉疾病(CAD)患者血清Lp(a)水平与LDL颗粒大小之间的关系。此外，我们还研究了sd-LDL和Lp(a)与CAD的范围和严重程度之间的关系。
共对490例因胸痛接受冠状动脉造影的患者(平均年龄：60.5±11.5岁)进行了研究。患者被分为两组，CAD组(n = 256)，冠状动脉造影显示有明显狭窄；对照组(n = 234)，冠状动脉正常或仅有轻微病变。CAD严重程度采用Gensini评分进行测量。使用Quantimetrix Lipoprint LDL系统分析LDL亚组分的分布。
血清Lp(a)浓度与sd-LDL比例(r = 0.193，p < 0.001)和平均LDL大小(r = 0.160，p = 0.003)相关。Lp(a)水平和平均LDL颗粒大小与高Gensini评分显著相关。CAD组的LDL颗粒大小小于对照组(26.74±0.64 vs. 26.43±0.93 nm，p < 0.001)。Lp(a)水平高的小LDL组的Gensini评分显著更高。
证实了Lp(a)水平与sd-LDL比例呈正相关。这种关联的机制尚不清楚；我们可以推测，它可能源于与氧化应激增加相关的个体致动脉粥样硬化状态。Lp(a)升高和sd-LDL比例增加均与CAD的严重程度相关。
