Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Atherosclerosis. 2010 May;210(1):278-81. doi: 10.1016/j.atherosclerosis.2009.11.006. Epub 2009 Nov 10.
Retinal vein occlusion (RVO) is one of the most common retinal vascular disorders affecting ocular vessels. Few studies, with conflicting results and conducted in limited study populations, have hypothesised the role of high levels of lipoprotein (a) [Lp(a)] in the occurrence of RVO. The aim of this study was to investigate, in a large group of RVO patients, the role of such an emerging thrombophilic parameter on the pathogenesis of RVO.
We compared 262 patients [median age: 66 years (15-88); 122 M, 140 F] with 262 age- and sex-comparable healthy subjects.
Circulating concentrations of Lp(a) were found to be significantly different in patients when compared to healthy subjects [189 (60-1898)mg/L vs. 119.5 (6-1216)mg/L; p<0.0001, respectively]. No significant differences were observed relating to the different types of occlusion (central or branch occlusion). In order to investigate the possible association between high Lp(a) levels and the disease we performed a logistic regression analysis. In the univariate analysis, Lp(a) levels>300mg/L were found to be associated with an increased risk of RVO (OR: 2.39, 95%CI 1.39-3.59; p<0.0001). Following this, three models of multivariate analysis were performed, firstly by adjusting for age, gender, and traditional cardiovascular risk factors, secondly for triglycerides and thirdly for homocysteine levels. In all the models, Lp(a) levels>300mg/L confirmed their role as a risk factor for RVO [first model, OR: 2.15 (95%CI 1.39-3.32), p=0.0001; second model, OR: 3.11 (95%CI 1.77-5.62), p<0.00001; third model, OR: 3.48 (95%CI 1.88-6.43), p<0.00001].
This study reports that, in a large population of RVO patients, high Lp(a) concentrations are significantly related to RVO, independent from other traditional and emerging risk factors, suggesting that they may play a role in its pathogenesis.
视网膜静脉阻塞（RVO）是一种常见的影响眼部血管的视网膜血管疾病。少数研究假设脂蛋白（a）[Lp（a）]水平升高在 RVO 的发生中起作用，但结果存在冲突，且研究人群有限。本研究旨在对大量 RVO 患者进行研究，以探讨这种新兴的血栓形成参数在 RVO 发病机制中的作用。
我们比较了 262 例 RVO 患者[中位年龄：66 岁（15-88 岁）；122 例男性，140 例女性]和 262 例年龄和性别相匹配的健康对照者。
与健康对照组相比，患者的循环 Lp（a）浓度明显不同[189（60-1898）mg/L vs. 119.5（6-1216）mg/L；p<0.0001]。不同类型的阻塞（中央或分支阻塞）之间未见明显差异。为了研究高 Lp（a）水平与疾病之间的可能关联，我们进行了 logistic 回归分析。在单因素分析中，Lp（a）水平>300mg/L 与 RVO 风险增加相关（OR：2.39，95%CI 1.39-3.59；p<0.0001）。在此基础上，我们进行了三种多变量分析模型，首先调整年龄、性别和传统心血管危险因素，其次调整甘油三酯，最后调整同型半胱氨酸水平。在所有模型中，Lp（a）水平>300mg/L 均证实了其作为 RVO 危险因素的作用[第一模型，OR：2.15（95%CI 1.39-3.32），p=0.0001；第二模型，OR：3.11（95%CI 1.77-5.62），p<0.00001；第三模型，OR：3.48（95%CI 1.88-6.43），p<0.00001]。
本研究报告称，在大量 RVO 患者中，高 Lp（a）浓度与 RVO 显著相关，独立于其他传统和新兴危险因素，提示其可能在其发病机制中起作用。
