Vladimirova-Kitova Lyudmila G, Deneva-Koicheva Tania I, Nikolov Fedya P, Ganev Varban S
Clinic of Cardiology, Medical University, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 2010 Oct-Dec;52(4):13-22. doi: 10.2478/v10153-010-012-3.
The results of the research of early vascular alterations in LDL-R carriers in comparison with those in non-carriers with severe hypercholesterolemia are controversial.
To investigate the difference between severe hypercholesterolemia patients that carry LDL-R defective gene and those that do not have it, in their functional (flow-mediated vasodilation) and structural (intima-media thickness of carotid artery and ankle-brachial index) characteristics of arterial wall.
The study included 120 hypercholesterolemic patients. Biochemistry parameters were studied by routine methods. The flow-mediated vasodilation (%FMD), ankle-brachial index (ABI) and intima-media thickness (IMT) of common carotid artery were determined using Hewlett Packard Sonos 5 500; MedicaSoft. IMT.lab was the software programme used in the study.
There was no significant difference between the groups with respect to total cholesterol, LDL, HDL, Apo-B, Apo-A1, cellular adhesion molecules (sICAM-1, sVCAM-1, sP- and sE-selectine). The Apo-B/Apo A1 index differed significantly (t = 11.23, p < 0.001) between the two groups; there was difference even after adjustment for age. There was no significant difference in the endothelial dependent and independent vasodilatation between the examined groups (p > 0.05). We found a significantly greater carotid IMT and lower ABI in the carriers than the respective parameters in the non-carriers. This significant difference was confirmed after adjustment for age.
Our data show that LDL-R carriers have a higher carotid IMT and lower ABI than non-carriers, whereas no difference between the groups was found with respect to the level of lipid parameters and %FMD.
与严重高胆固醇血症非携带者相比,低密度脂蛋白受体(LDL-R)携带者早期血管改变的研究结果存在争议。
研究携带LDL-R缺陷基因的严重高胆固醇血症患者与未携带该基因的患者在动脉壁功能(血流介导的血管舒张)和结构(颈动脉内膜中层厚度及踝臂指数)特征方面的差异。
该研究纳入了120例高胆固醇血症患者。采用常规方法研究生化参数。使用惠普Sonos 5500;MedicaSoft测定颈总动脉的血流介导的血管舒张(%FMD)、踝臂指数(ABI)和内膜中层厚度(IMT)。IMT.lab是该研究中使用的软件程序。
两组在总胆固醇、低密度脂蛋白、高密度脂蛋白、载脂蛋白B、载脂蛋白A1、细胞黏附分子(可溶性细胞间黏附分子-1、可溶性血管细胞黏附分子-1、可溶性P-选择素和可溶性E-选择素)方面无显著差异。两组间载脂蛋白B/载脂蛋白A1指数差异显著(t = 11.23,p < 0.001);即使在调整年龄后仍存在差异。各研究组之间内皮依赖性和非依赖性血管舒张无显著差异(p > 0.05)。我们发现携带者的颈动脉IMT显著高于非携带者,ABI则显著低于非携带者。在调整年龄后,这一显著差异得到证实。
我们的数据表明,与非携带者相比,LDL-R携带者的颈动脉IMT更高,ABI更低,而两组在血脂参数水平和%FMD方面未发现差异。