家族性高胆固醇血症和家族性混合型高脂血症患者的颈动脉粥样硬化和脂蛋白颗粒亚类。

Carotid atherosclerosis and lipoprotein particle subclasses in familial hypercholesterolaemia and familial combined hyperlipidaemia.

机构信息

Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud, Avda. Isabel La Católica 1-3, Zaragoza, Spain.

出版信息

Nutr Metab Cardiovasc Dis. 2012 Jul;22(7):591-7. doi: 10.1016/j.numecd.2010.10.011. Epub 2010 Dec 31.

DOI:10.1016/j.numecd.2010.10.011

PMID:21196102

Abstract

BACKGROUND AND AIMS

Familial hypercholesterolaemia (FH) and familial combined hyperlipidaemia (FCH) are common atherogenic disorders with great variability in cardiovascular disease (CVD). No direct atherosclerosis burden comparisons have been performed between FH and FCH in relation to lipoprotein particle distribution.

METHODS AND RESULTS

Risk factors and three measures of carotid intima-media thickness (IMT) in both sides were determined in 572 FH, 250 FCH and 200 controls. Lipoproteins were assessed by nuclear magnetic resonance (NMR) spectroscopy. Compared with controls, IMT measures were increased in FH and FCH. FCH had the highest adjusted mean-maximum IMT. FH had twice low-density lipoprotein (LDL) particles than controls, but similar LDL subclass size and distribution. FCH subjects also had increased LDL particles and the highest number of small LDL (1519 ± 731 nmol l(-1) vs. 887 ± 784 nmol l(-1) in FH and 545 ± 409 nmol l(-1) in controls). Age, gender, cholesterol/high-density lipoprotein (HDL) ratio, smoking and systolic blood pressure were independently associated with IMT in FH (r(2) = 0.38). The same variables, except cholesterol/HDL ratio, were associated with IMT in FCH (r(2) = 0.40). Among NMR lipoproteins, only VLDL and chylomicrons increased IMT prediction in FCH by 0.8%.

CONCLUSION

FH and FCH subjects show increased carotid atherosclerosis in relation to classical risk factors. Lipoprotein subclasses do not substantially contribute to IMT variability.

摘要

背景与目的

家族性高胆固醇血症（FH）和家族性混合型高脂血症（FCH）是常见的动脉粥样硬化性疾病，心血管疾病（CVD）的变异性很大。脂蛋白颗粒分布方面，尚未对 FH 和 FCH 之间的动脉粥样硬化负担进行直接比较。

方法和结果

在 572 例 FH、250 例 FCH 和 200 例对照中，测定了危险因素和两侧颈动脉内膜中层厚度（IMT）的三个测量值。采用核磁共振（NMR）光谱法评估脂蛋白。与对照组相比，FH 和 FCH 的 IMT 测量值均增加。FCH 的校正平均最大 IMT 最高。FH 的低密度脂蛋白（LDL）颗粒数是对照组的两倍，但 LDL 亚类大小和分布相似。FCH 患者的 LDL 颗粒也增加，小 LDL 数量最多（1519±731 nmol/L 比 FH 中的 887±784 nmol/L 和对照组中的 545±409 nmol/L）。年龄、性别、胆固醇/高密度脂蛋白（HDL）比值、吸烟和收缩压与 FH 的 IMT 独立相关（r²=0.38）。除胆固醇/HDL 比值外，相同变量与 FCH 的 IMT 相关（r²=0.40）。在 NMR 脂蛋白中，只有 VLDL 和乳糜微粒使 FCH 的 IMT 预测增加了 0.8%。