Clarenbach Jacob J, Grundy Scott M, Palacio Natalia, Vega Gloria Lena
Center for Human Nutrition, the Donald W Reynolds Cardiovascular Research Center of the University of Texas Southwestern Medical Center at Dallas, TX 75390-9052, USA.
J Investig Med. 2007 Jul;55(5):237-47. doi: 10.2310/6650.2007.00004.
Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy. However, all lipoproteins containing apolipoprotein B (apo B) appear to be atherogenic. Preferred targets of therapy therefore may include either the cholesterol in all apo B-containing lipoproteins (non-high-density lipoprotein cholesterol [non-HDL-C]) or total apo B itself. Apo B can be measured by three methods: chemically, by nuclear magnetic resonance (NMR), and by immunoassay. This study compares the first two methods as a function of the number of metabolic risk factors in patients with metabolic syndrome. Plasma lipid, lipoprotein cholesterol, and apo B levels were measured in 274 adults with varying numbers of metabolic syndrome components. Low-density lipoprotein (LDL) particle sizes were measured by gel electrophoresis and by NMR. Total apo B was estimated chemically and by conversion of NMR lipoprotein particle number, assuming one apo B molecule per lipoprotein particle. As the number of metabolic syndrome components increased, apo B rose by both chemical and NMR methods, but by chemical methods, increases were in the triglyceride-rich fraction, whereas by NMR, they were in LDL. The correlation between total apo B measured by the two methods was only moderate (r = .73). Further, non-HDL-C was more highly correlated with total apo B measured chemically than either LDL-C or total apo B by NMR. Non-HDL-C correlates highly with total apo B in patients with metabolic syndrome and had advantages as a target of therapy over LDL-C or NMR apo B.
低密度脂蛋白胆固醇（LDL-C）是降脂治疗的主要靶点。然而，所有含有载脂蛋白B（apo B）的脂蛋白似乎都具有致动脉粥样硬化性。因此，治疗的首选靶点可能包括所有含apo B脂蛋白中的胆固醇（非高密度脂蛋白胆固醇[non-HDL-C]）或总apo B本身。apo B可通过三种方法测量：化学法、核磁共振（NMR）法和免疫分析法。本研究比较了前两种方法在代谢综合征患者中作为代谢危险因素数量的函数关系。对274名具有不同数量代谢综合征组分的成年人测量了血浆脂质、脂蛋白胆固醇和apo B水平。通过凝胶电泳和NMR测量低密度脂蛋白（LDL）颗粒大小。通过化学法并根据NMR脂蛋白颗粒数量进行换算（假设每个脂蛋白颗粒有一个apo B分子）来估算总apo B。随着代谢综合征组分数量的增加，化学法和NMR法测得的apo B均升高，但化学法测得的升高存在于富含甘油三酯的部分，而NMR法测得的升高存在于LDL中。两种方法测得的总apo B之间的相关性仅为中等（r = 0.73）。此外，与通过NMR测得的LDL-C或总apo B相比，non-HDL-C与化学法测得的总apo B的相关性更高。在代谢综合征患者中，non-HDL-C与总apo B高度相关，并且作为治疗靶点比LDL-C或NMR apo B具有优势。
