Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil.
J Heart Lung Transplant. 2009 Oct;28(10):1075-80. doi: 10.1016/j.healun.2009.05.024.
Beyond the first year after a heart transplant (HT) procedure, patients often develop dyslipidemias, which may be implicated in the genesis of transplant coronary heart disease. High-density lipoprotein (HDL) has a several anti-atherogenic properties, but the status of HDL in HT patients is still controversial. Nonetheless, determination of HDL cholesterol concentration is not sufficient for evaluation of the overall HDL protective role. In this study, a fundamental functional property of HDL, the ability to simultaneously receive the major lipid classes, was tested in HT patients.
Twenty HT patients and 20 healthy normolipidemic subjects paired for gender, age and body mass index were studied. Blood samples were collected after 12-hour fasting for determination of plasma lipids, glucose, paraxonase 1 (PON 1) activity, HDL diameter and transfer of labeled lipids from an artificial nanoemulsion to HDL.
Plasma triglycerides (159 +/- 63 vs 94 +/- 35 mg/dl) and glucose (104 +/- 20 vs 86 +/- 10 mg/dl) were greater in HT patients than in control subjects. HDL cholesterol was lower and HDL diameter was smaller in the HT group (HDL cholesterol: 44 +/- 11 vs 55 +/- 15 mg/dl; HDL diameter: 8.8 +/- 0.6 vs 9.0 +/- 1.2 nm). PON 1 activity did not differ (87 +/- 47 vs 75 +/- 37 nmol/min/ml). The transfer rates of free cholesterol and cholesteryl esters were diminished in HT patients (HT: 8.4 +/- 1.2% and 3.8 +/- 0.6%; controls: 9.7 +/- 1.9% and 4.7 +/- 1.2%, respectively).
The transfer of free cholesterol and cholesteryl esters to HDL is diminished in HT patients; disturbance in the ability of HDL to receive lipids may affect the anti-atherogenic properties of the lipoprotein.
心脏移植（HT）术后 1 年以上，患者常发生血脂异常，可能与移植后冠心病的发生有关。高密度脂蛋白（HDL）具有多种抗动脉粥样硬化特性，但 HT 患者的 HDL 状况仍存在争议。然而，HDL 胆固醇浓度的测定对于评估 HDL 的整体保护作用是不够的。在这项研究中，我们检测了 HT 患者的 HDL 的一个基本功能特性，即同时接受主要脂质类别的能力。
20 例 HT 患者和 20 例性别、年龄和体重指数相匹配的健康血脂正常对照者纳入研究。空腹 12 小时后采集血样，测定血浆脂质、血糖、对氧磷酶 1（PON1）活性、HDL 直径和人工纳米乳剂中标记脂质向 HDL 的转移。
与对照组相比，HT 患者的血浆甘油三酯（159 ± 63 比 94 ± 35mg/dl）和血糖（104 ± 20 比 86 ± 10mg/dl）更高。HT 组的 HDL 胆固醇水平较低，HDL 直径较小（HDL 胆固醇：44 ± 11 比 55 ± 15mg/dl；HDL 直径：8.8 ± 0.6 比 9.0 ± 1.2nm）。PON1 活性无差异（87 ± 47 比 75 ± 37nmol/min/ml）。HT 患者的游离胆固醇和胆固醇酯的转移率降低（HT：8.4 ± 1.2%和 3.8 ± 0.6%；对照组：9.7 ± 1.9%和 4.7 ± 1.2%）。
HT 患者的游离胆固醇和胆固醇酯向 HDL 的转移减少；HDL 摄取脂质的能力受损可能会影响脂蛋白的抗动脉粥样硬化特性。
