Hitsumoto Takashi, Takahashi Mao, Iizuka Takuo, Shirai Kohji
Department of Internal Medicine, Sakura Hospital, Toho University School of Medicine, Chiba, Japan.
J Atheroscler Thromb. 2008 Jun;15(3):138-45. doi: 10.5551/jat.e547.
Lipoprotein lipase protein exists in preheparin serum (preheparin LpL mass), even though lipoprotein lipase activity is rarely detected. Recent clinical studies have clarified that low preheparin LpL mass concentration is an important coronary risk factor. The aim of this study was to clarify the effect of telmisartan, which is an angiotensin II receptor antagonist with partial peroxisome proliferator-activated receptor-gamma agonist activity, on preheparin LpL mass concentration in the serum of patients with hypertension.
Fifty untreated hypertensive patients were treated with telmisartan 40 mg/day for 12 weeks and the subjects were divided into two groups by their mean value of preheparin LpL mass concentration at baseline (cut-off level: Male 55 ng/mL, Female 65 ng/mL).
Before telmisartan therapy, low preheparin LpL mass concentration was closely associated with the pathogenesis of insulin resistance and the presence of coronary atherosclerosis. Preheparin LpL mass concentration significantly increased after telmisartan therapy in subjects with a low preheparin LpL mass concentration (baseline/12 weeks after, 46 +/- 12 ng/mL/54 +/- 14 ng/mL, p=0.001).
This finding indicated that telmisartan could prevent the occurrence of coronary events in subjects with hypertension by increasing the preheparin LpL mass concentration.
尽管很少检测到脂蛋白脂肪酶活性，但脂蛋白脂肪酶蛋白存在于肝素前血清中（肝素前脂蛋白脂肪酶质量）。最近的临床研究已阐明，低肝素前脂蛋白脂肪酶质量浓度是一个重要的冠心病危险因素。本研究的目的是阐明替米沙坦（一种具有部分过氧化物酶体增殖物激活受体γ激动剂活性的血管紧张素II受体拮抗剂）对高血压患者血清中肝素前脂蛋白脂肪酶质量浓度的影响。
50名未经治疗的高血压患者接受替米沙坦40mg/天治疗12周，并根据其基线时肝素前脂蛋白脂肪酶质量浓度的平均值（临界值：男性55ng/mL，女性65ng/mL）分为两组。
在替米沙坦治疗前，低肝素前脂蛋白脂肪酶质量浓度与胰岛素抵抗的发病机制和冠状动脉粥样硬化的存在密切相关。在肝素前脂蛋白脂肪酶质量浓度低的受试者中，替米沙坦治疗后肝素前脂蛋白脂肪酶质量浓度显著升高（基线/治疗12周后，46±12ng/mL/54±14ng/mL，p = 0.001）。
这一发现表明，替米沙坦可通过提高肝素前脂蛋白脂肪酶质量浓度来预防高血压患者发生冠状动脉事件。
