Gaeta Giovanni, Cuomo Sergio, Capozzi Giovanbattista, Foglia Maria C, Barra Silvia, Madrid Alfredo, Stornaiuolo Vincenzo, Trevisan Maurizio
Division of Cardiology, A. Cardarelli Hospital, Naples, Italy.
Nutr Metab Cardiovasc Dis. 2008 Sep;18(7):492-6. doi: 10.1016/j.numecd.2007.03.006. Epub 2007 Oct 24.
Most but not all studies in children, adolescents and young adults with a family history of coronary artery disease have reported an increase in lipoprotein(a) (Lp(a)) concentrations. The aim of this study was to assess if healthy children, adolescents and young adults with a parental history of premature myocardial infarction (PHPMI) have increased Lp(a) levels and are at higher risk of elevated (>30 mg/dl) Lp(a) concentrations.
One hundred fifty healthy children, adolescents and young adults with PHPMI (55% males; age 18+/-6.7 years) and 150 age- (+/-1 year) and gender-matched control subjects participated in the study. Concentrations of total plasma cholesterol, low-density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)-cholesterol, apolipoprotein (Apo) A-I and B, triglycerides and Lp(a) were determined after fasting for 14 h. Participants with PHPMI had higher concentrations of LDL-cholesterol (107.9+/-31.1 vs. 99.2+/-28.7 mg/dl, p=0.01), Apo B (89.6+/-26.4 vs. 82.8+/-20.2 mg/dl, p=0.011) and Lp(a) (26.7+/-34.0 vs. 19.2+/-23.2 mg/dl, p=0.012) and lower HDL-cholesterol concentrations (47.9+/-11.3 vs. 50.7+/-13.9 mg/dl, p=0.038) than participants without PHPMI. Thirty percent of PHPMI positive subjects had elevated Lp(a) concentrations vs. 16.7% of PHPMI negative subjects (p=0.009; relative risk 2.14; 95% CI 1.23-3.73). In a conditional logistic regression analysis, Lp(a) concentration was significantly and independently associated with PHPMI.
Healthy young subjects with PHPMI have increased Lp(a) levels, a higher risk for elevated Lp(a) concentrations within an unfavourable lipid profile.
大多数（但并非所有）针对有冠状动脉疾病家族史的儿童、青少年和年轻人的研究报告称脂蛋白(a)（Lp(a)）浓度有所升高。本研究的目的是评估有父母早发心肌梗死病史（PHPMI）的健康儿童、青少年和年轻人的Lp(a)水平是否升高，以及Lp(a)浓度升高（>30mg/dl）的风险是否更高。
150名有PHPMI的健康儿童、青少年和年轻人（55%为男性；年龄18±6.7岁）以及150名年龄（±1岁）和性别匹配的对照受试者参与了研究。在禁食14小时后测定总血浆胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、载脂蛋白（Apo）A-I和B、甘油三酯以及Lp(a)的浓度。有PHPMI的参与者的LDL胆固醇（107.9±31.1 vs. 99.2±28.7mg/dl，p=0.01）、Apo B（89.6±26.4 vs. 82.8±20.2mg/dl，p=0.011）和Lp(a)（26.7±34.0 vs. 19.2±23.2mg/dl，p=0.012）浓度更高，而HDL胆固醇浓度更低（47.9±11.3 vs. 50.7±13.9mg/dl，p=0.038）。30%的PHPMI阳性受试者Lp(a)浓度升高，而PHPMI阴性受试者为16.7%（p=0.009；相对风险2.14；95%CI 1.23 - 3.73）。在条件逻辑回归分析中，Lp(a)浓度与PHPMI显著且独立相关。
有PHPMI的健康年轻受试者Lp(a)水平升高，在不利的血脂谱中Lp(a)浓度升高的风险更高。
