3rd Department of Internal Medicine, University Hospital, IP Pavlova 6, 77520 Olomouc, Czech Republic.
J Thromb Thrombolysis. 2011 Jan;31(1):27-36. doi: 10.1007/s11239-010-0474-4.
The aim of this study was to evaluate the plasma levels of prothrombotic markers--von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA)--in asymptomatic subjects with dyslipidemia. Asymptomatic subjects with dyslipidemia and their relatives (n = 234) were assessed for lipids and prothrombotic markers. Individuals were divided into four dyslipidemic phenotypes (DLP) according to apolipoprotein B (apoB) and triglycerides (TG): DLP1 (n = 58, apoB < 1.2 g/l and TG < 1.5 mmol/l), DLP2 (n = 47, apoB < 1.2 g/l and TG ≥ 1.5 mmol/l), DLP3 (n = 31, apoB ≥ 1.2 g/l and TG < 1.5 mmol/l) and DLP4 (n = 98, apoB ≥ 1.2 g/l and TG ≥ 1.5 mmol/l). Associations between prothrombotic markers and risk factors for atherosclerosis, markers of insulin resistance, and the intima-media thickness of the common carotid artery (IMT) were assessed too. Significant differences in PAI-1 between normolipidemic phenotype--DLP1 (62.5 (35.9-82.9) ng/ml) and hypertriglyceridemic phenotypes--DLP2 (82.2 (61.1-122.1) ng/ml, p < 0.01) and DLP4 (91.4 (63.5-111.8) ng/ml, p < 0.001) after adjustment for age, sex and body mass index, were found. Levels of t-PA were different only between DLP1 and DLP4 (1.9 (0.9-3.3) ng/ml vs. 5.3 (2.5-8.6) ng/ml, p < 0.05). There were no significant differences of vWF between DLPs. PAI-1 and t-PA correlated with lipid parameters, markers of insulin resistance, blood pressure and obesity. VWF was independently associated with IMT, which was increased in DLP4. Individuals with hypertriglyceridemic phenotypes showed increased levels of PAI-1 in comparison with normolipidemic subjects. The elevation of t-PA was presented only in patients with simultaneously elevated TG and apoB. The significant increase of IMT confirmed in the patients with DLP4 reveals individuals with the highest risk for atherosclerosis manifestation.
本研究旨在评估无症状血脂异常患者的血栓形成标志物血浆水平 - 血管性血友病因子（vWF）、纤溶酶原激活物抑制剂-1（PAI-1）、组织型纤溶酶原激活物（t-PA）。评估了 234 名无症状血脂异常患者及其亲属的血脂和血栓形成标志物。根据载脂蛋白 B（apoB）和甘油三酯（TG），将个体分为四种血脂异常表型（DLP）：DLP1（n = 58，apoB < 1.2g/l 且 TG < 1.5mmol/l）、DLP2（n = 47，apoB < 1.2g/l 且 TG ≥ 1.5mmol/l）、DLP3（n = 31，apoB ≥ 1.2g/l 且 TG < 1.5mmol/l）和 DLP4（n = 98，apoB ≥ 1.2g/l 且 TG ≥ 1.5mmol/l）。还评估了血栓形成标志物与动脉粥样硬化危险因素、胰岛素抵抗标志物和颈总动脉内膜-中层厚度（IMT）之间的关系。经过年龄、性别和体重指数调整后，在脂蛋白正常表型 DLP1（62.5（35.9-82.9）ng/ml）和高甘油三酯血症表型 DLP2（82.2（61.1-122.1）ng/ml，p < 0.01）和 DLP4（91.4（63.5-111.8）ng/ml，p < 0.001）之间发现 PAI-1 存在显著差异。t-PA 仅在 DLP1 和 DLP4 之间存在差异（1.9（0.9-3.3）ng/ml vs. 5.3（2.5-8.6）ng/ml，p < 0.05）。DLP 之间 vWF 无显著差异。PAI-1 和 t-PA 与脂质参数、胰岛素抵抗标志物、血压和肥胖有关。VWF 与 IMT 独立相关，DLP4 中 IMT 增加。与脂蛋白正常的受试者相比，高甘油三酯血症表型的患者 PAI-1 水平升高。仅在同时升高 TG 和 apoB 的患者中观察到 t-PA 的升高。在 DLP4 患者中证实的 IMT 显著增加表明这些患者发生动脉粥样硬化表现的风险最高。
