小载脂蛋白（a）异构体与小而密低密度脂蛋白对冠心病风险的联合作用。

Combined effects of small apolipoprotein (a) isoforms and small, dense LDL on coronary artery disease risk.

作者信息

Zeljkovic Aleksandra, Bogavac-Stanojevic Natasa, Jelic-Ivanovic Zorana, Spasojevic-Kalimanovska Vesna, Vekic Jelena, Spasic Slavica

机构信息

Institute of Medical Biochemistry, Faculty of Pharmacy, Belgrade, Serbia.

出版信息

Arch Med Res. 2009 Jan;40(1):29-35. doi: 10.1016/j.arcmed.2008.10.010.

DOI:10.1016/j.arcmed.2008.10.010

PMID:19064124

Abstract

BACKGROUND AND AIMS

Lipoprotein (a) [Lp(a)] consists of low-density lipoprotein (LDL) and apolipoprotein (a) [apo(a)]. Both Lp(a) constituents are well-recognized risk factors for coronary artery disease (CAD). This study investigates the interrelationship of apo(a) and LDL size, as well as their possible synergistic effect on the increase of CAD risk.

METHODS

One hundred nine CAD patients and 102 apparently healthy subjects were included in the study. Lp(a) concentration was measured using immunoturbidimetry. The sizes of apo(a) isoforms were determined by SDS-agarose gel electrophoresis followed by immunoblotting. LDL particle size was determined by gradient gel electrophoresis.

RESULTS

We found an inverse correlation between apo(a) size and Lp(a) concentration (r(2) = 31%, p <0.001 in the control group and r(2) = 35%, p <0.001 in the CAD group). Individuals with smaller apo(a) isoforms and small, dense LDL (sdLDL) >50% had the highest risk of CAD development (OR = 4.23, p = 0.017). The synergy index (SIM) for the combination of smaller apo(a) isoforms and sdLDL >50% was 1.2. Adjustment for Lp(a) and triacylglycerol concentrations eliminated smaller apo(a)/sdLDL >50% related risk (p = 0.233 and p = 0.09, respectively).

CONCLUSIONS

Smaller apo(a) isoforms appear to be superior to sdLDL for the assessment of CAD risk. Their combined effect is synergistic.

摘要

背景与目的

脂蛋白(a)[Lp(a)]由低密度脂蛋白(LDL)和载脂蛋白(a)[apo(a)]组成。Lp(a)的这两种成分都是公认的冠状动脉疾病(CAD)风险因素。本研究调查了apo(a)与LDL大小的相互关系，以及它们对CAD风险增加可能的协同作用。

方法

本研究纳入了109例CAD患者和102例明显健康的受试者。采用免疫比浊法测定Lp(a)浓度。通过SDS-琼脂糖凝胶电泳随后进行免疫印迹法测定apo(a)异构体的大小。通过梯度凝胶电泳测定LDL颗粒大小。

结果

我们发现apo(a)大小与Lp(a)浓度呈负相关(r² = 31%，对照组p <0.001；r² = 35%，CAD组p <0.001)。apo(a)异构体较小且小而密LDL(sdLDL)>50%的个体发生CAD的风险最高(OR = 4.23，p = 0.017)。apo(a)异构体较小和sdLDL>50%组合的协同指数(SIM)为1.2。对Lp(a)和三酰甘油浓度进行校正后，消除了apo(a)较小/sdLDL>50%相关的风险(分别为p = 0.233和p = 0.09)。