Sabino Adriano Paula, De Oliveira Sousa Marinez, Moreira Lima Luciana, Dias Ribeiro Daniel, Sant'Ana Dusse Luci Maria, Das Graças Carvalho Maria, Fernandes Ana Paula
Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil, University Hospital-Federal University of Minas Gerais Belo Horizonte, MG, Brazil.
Transl Res. 2008 Sep;152(3):113-8. doi: 10.1016/j.trsl.2008.06.005. Epub 2008 Jul 21.
Although smoking and hypertension are classic risk factors for atherothrombotic diseases, the relationship of dyslipidemia and vascular diseases, other than myocardial infarction, is less clearly established, especially in young subjects. In the current study, a detailed analysis of the lipid and apolipoprotein profiles was conducted in young patients of ischemic cerebral stroke (IS) and peripheral arterial disease (PAD). Plasma levels of C-reactive protein (hs-CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides (TG), and apolipoproteins A-I (ApoA-I) and apolipoproteins B (ApoB), which include the ApoB/ApoA-I ratio, were analyzed in a group of 81 patients who presented with IS (n = 46) or PAD (n = 35) as well as in 167 control subjects. Significant differences were observed for hs-CRP, TC, HDLc, LDLc, TG, ApoA-I, and ApoB levels, as well as for the ApoB/ApoA-I ratio, between the control and the IS or PAD groups. However, after adjustment for sex, age, smoking, hypertension, hs-CRP, and dyslipidemia (LDLc, TC, HDLc, TG, ApoA, ApoB, and ApoB/ApoA-I ratio), hs-CRP, ApoB, and the ApoB/ApoA-I ratio were independently associated with increased risks of IS or PAD. Increased ApoB/ApoA-I ratio and hs-CRP levels are independently associated with occurrence of IS and PAD in young patients and are significant markers of alterations on lipid and apolipoproteic profiles and inflammatory responses, respectively, in these patients.
尽管吸烟和高血压是动脉粥样硬化血栓形成性疾病的典型危险因素，但除心肌梗死外，血脂异常与血管疾病之间的关系尚不明确，尤其是在年轻人群中。在本研究中，对缺血性脑卒中（IS）和外周动脉疾病（PAD）的年轻患者进行了血脂和载脂蛋白谱的详细分析。对81例患有IS（n = 46）或PAD（n = 35）的患者以及167例对照者的血浆C反应蛋白（hs-CRP）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDLc）、低密度脂蛋白胆固醇（LDLc）、甘油三酯（TG）以及载脂蛋白A-I（ApoA-I）和载脂蛋白B（ApoB，包括ApoB/ApoA-I比值）水平进行了分析。在对照组与IS或PAD组之间，观察到hs-CRP、TC、HDLc、LDLc、TG、ApoA-I和ApoB水平以及ApoB/ApoA-I比值存在显著差异。然而，在对性别、年龄、吸烟、高血压、hs-CRP和血脂异常（LDLc、TC、HDLc、TG、ApoA、ApoB和ApoB/ApoA-I比值）进行校正后，hs-CRP、ApoB和ApoB/ApoA-I比值与IS或PAD风险增加独立相关。ApoB/ApoA-I比值升高和hs-CRP水平升高分别与年轻患者IS和PAD的发生独立相关，并且分别是这些患者血脂和载脂蛋白谱改变以及炎症反应的重要标志物。
