Center E. Grossi Paoletti, Università degli Studi di Milano, Milano, Italy.
J Lipid Res. 2011 Aug;52(8):1569-74. doi: 10.1194/jlr.P014977. Epub 2011 May 19.
Lecithin:cholesterol acyltransferase (LCAT) is the enzyme responsible for cholesterol esterification in plasma. LCAT is a major factor in HDL remodeling and metabolism, and it has long been believed to play a critical role in macrophage reverse cholesterol transport (RCT). The effect of LCAT on human atherogenesis is still controversial. In the present study, the plasma LCAT concentration was measured in all subjects (n = 540) not on drug treatment at the time of enrollment in the multicenter, longitudinal, observational IMPROVE study. Mean and maximum intima-media thickness (IMT) of the whole carotid tree was measured by B-mode ultrasonography in all subjects. In the entire cohort, LCAT quartiles were not associated with carotid mean and maximum IMT (P for trend 0.95 and 0.18, respectively), also after adjustment for age, gender, HDL-cholesterol (HDL-C), and triglycerides. No association between carotid IMT and LCAT quartiles was observed in men (P=0.30 and P=0.99 for mean and maximum IMT, respectively), whereas carotid IMT increased with LCAT quartiles in women (P for trend 0.14 and 0.019 for mean and maximum IMT, respectively). The present findings support the concept that LCAT is not required for an efficient reverse cholesterol transport and that a low plasma LCAT concentration and activity is not associated with increased atherosclerosis.
卵磷脂胆固醇酰基转移酶（LCAT）是血浆中胆固醇酯化的酶。LCAT 是 HDL 重塑和代谢的主要因素，长期以来一直被认为在巨噬细胞胆固醇逆转运（RCT）中发挥关键作用。LCAT 对人类动脉粥样硬化形成的影响仍存在争议。在本研究中，在多中心、纵向、观察性 IMPROVE 研究入组时，所有未接受药物治疗的受试者（n = 540）均测量了血浆 LCAT 浓度。所有受试者均通过 B 型超声测量整个颈动脉树的平均内膜中层厚度（IMT）和最大 IMT。在整个队列中，LCAT 四分位间距与颈动脉平均和最大 IMT 无关（趋势 P 值分别为 0.95 和 0.18），即使在调整年龄、性别、高密度脂蛋白胆固醇（HDL-C）和甘油三酯后也是如此。在男性中，颈动脉 IMT 与 LCAT 四分位间距之间没有关联（平均 IMT 和最大 IMT 的 P 值分别为 0.30 和 0.99），而在女性中，颈动脉 IMT 随 LCAT 四分位间距增加而增加（平均 IMT 和最大 IMT 的趋势 P 值分别为 0.14 和 0.019）。本研究结果支持 LCAT 不是有效胆固醇逆转运所必需的这一概念，并且低血浆 LCAT 浓度和活性与动脉粥样硬化增加无关。
