在伴有高三酰甘油血症的代谢综合征患者中，载脂蛋白 B 和非高密度脂蛋白胆固醇比低密度脂蛋白胆固醇更能作为冠心病的风险标志物。

Apolipoprotein B and non-high-density lipoprotein cholesterol are better risk markers for coronary artery disease than low-density lipoprotein cholesterol in hypertriglyceridemic metabolic syndrome patients.

机构信息

Department of Biochemistry, University Hospital Shaloul, Sousse, Tunisia.

出版信息

Metab Syndr Relat Disord. 2010 Dec;8(6):515-22. doi: 10.1089/met.2010.0006. Epub 2010 Aug 17.

DOI:10.1089/met.2010.0006

PMID:20715933

Abstract

BACKGROUND

Metabolic syndrome is highly prevalent in the general population. Small dense low-density lipoprotein (sd-LDL) particles have been considered as a risk marker in metabolic syndrome diagnosis. Apolipoprotein B (ApoB) concentration reflects the number of LDL particles and is closely associated with atherosclerosis. The aim of this study was to compare the associations of ApoB, non-high-density lipoprotein cholesterol (NHDL-C), and low-density lipoprotein cholesterol (LDL-C) with metabolic syndrome and its relationship with significant coronary stenosis (SCS) in a Tunisian population.

METHODS

We enrolled 192 patients, who underwent coronary angiography. The body mass index, blood lipids, fasting glucose, insulin concentration, and blood pressure of every patient were measured. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria.

RESULTS

The frequency of metabolic syndrome was 58.3%. The comparison of the lipidic parameters between subject with and without metabolic syndrome showed a significant increase in ApoB and NHDL-C but not in LDL-C. By considering triglyceride (TG) limits (TG ≤ 0.9 mmol/L and TG > 1.70 mmol/L), we noted no differences in ApoB, NHDL-C, and LDL-C between subjects with and without metabolic syndrome in triglyceridemia ≤0.9 mmol/L. In triglyceridemia >1.70 mmol/L, a significant increase in ApoB and NHDL-C, but not in LDL-C, was noted. These results seem to consolidate the probability of increased sd-LDL in hypertriglyceridemic metabolic syndrome subjects. Indeed, in our study the odds ratio (OR) of SCS associated with metabolic syndrome is 3.81 (P = 0.007) in the studied population. This risk increases to 8.70 (P = 0.026) in hypertriglyceridemic subjects and seems to be associated with ApoB and NHDL-C (OR = 1.87, P = 0.038; OR = 1.26, P = 0.048).

CONCLUSIONS

This study suggests that ApoB and NHDL-C seem to be more correlated to SCS in metabolic syndrome with hypertriglyceridemia than LDL-C.

摘要

背景

代谢综合征在普通人群中高度流行。小而密的低密度脂蛋白（sd-LDL）颗粒被认为是代谢综合征诊断中的一个风险标志物。载脂蛋白 B（ApoB）浓度反映了 LDL 颗粒的数量，与动脉粥样硬化密切相关。本研究旨在比较载脂蛋白 B（ApoB）、非高密度脂蛋白胆固醇（NHDL-C）和低密度脂蛋白胆固醇（LDL-C）与代谢综合征的相关性，并探讨其与突尼斯人群中显著冠状动脉狭窄（SCS）的关系。

方法

我们纳入了 192 名接受冠状动脉造影的患者。测量每位患者的体重指数、血脂、空腹血糖、胰岛素浓度和血压。根据国际糖尿病联合会的标准诊断代谢综合征。

结果

代谢综合征的发生率为 58.3%。比较有和无代谢综合征患者的脂质参数发现，ApoB 和 NHDL-C 显著增加，但 LDL-C 没有增加。考虑到甘油三酯（TG）的限制（TG≤0.9mmol/L 和 TG>1.70mmol/L），我们发现 TG≤0.9mmol/L 的患者中，ApoB、NHDL-C 和 LDL-C 在有和无代谢综合征之间没有差异。在 TG>1.70mmol/L 时，ApoB 和 NHDL-C 显著增加，但 LDL-C 没有增加。这些结果似乎证实了高甘油三酯血症代谢综合征患者中 sd-LDL 增加的可能性。事实上，在我们的研究中，代谢综合征与 SCS 相关的比值比（OR）在研究人群中为 3.81（P=0.007）。在高甘油三酯血症患者中，这一风险增加到 8.70（P=0.026），且似乎与 ApoB 和 NHDL-C 相关（OR=1.87，P=0.038；OR=1.26，P=0.048）。