Tekiner Esra, Oguz Aytekin, Uzunlulu Mehmet, Tekiner Fatih
Department of Internal Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey.
Acta Cardiol. 2011 Aug;66(4):433-8. doi: 10.1080/ac.66.4.2126590.
It is suggested that the apolipoprotein (Apo) B levels are more valuable than LDL cholesterol (LDL-C) levels in assessing cardiovascular risk associated with hyperlipidaemia. However, although non-HDL cholesterol (non-HDL-C) levels are accepted as a secondary objective after achieving LDL-C levels in the guidelines, Apo B has not been recommended as a therapeutic goal yet. The objective of this study was to determine how many of the patients who achieved the LDL-C and non-HDL-C target recommended by the guidelines with a statin therapy achieved the Apo B target.
The study included a total of 182 consecutive hypercholesterolaemic (119 male, 63 female) patients who were over 18 years of age (mean age: 54.96 +/- 9.27 y) and on statin therapy. Apo B and non-HDL-C levels were determined for the patients who achieved or did not achieve the LDL-C target according to the cardiovascular risk categories defined in the Adult Treatment Panel-III report. Serum Apo B levels were assessed using the nephelometric method.
The prevalence of patients who achieved the LDL-C, non-HDL-C and Apo B target was 63.2%, 79.7% and 72.5%, respectively. All of the patients who achieved the LDL-C target also achieved the non-HDL-C target. It was found that 6 of 115 patients (5.2%) who achieved the LDL-C and non-HDL-C target failed to achieve the Apo B target, whereas 23 of 132 patients (17.4%) who achieved the Apo B target failed to achieve the LDL-C target.
These results showed that 95% of patients who received a statin therapy, and achieved LDL-C and non-HDL-C targets also achieved the Apo B target.
有研究表明,在评估高脂血症相关心血管风险方面,载脂蛋白(Apo)B水平比低密度脂蛋白胆固醇(LDL-C)水平更具价值。然而,尽管在指南中,非高密度脂蛋白胆固醇(non-HDL-C)水平在达到LDL-C水平后被视为次要目标,但Apo B尚未被推荐作为治疗目标。本研究的目的是确定在接受他汀类药物治疗且达到指南推荐的LDL-C和non-HDL-C目标的患者中,有多少患者达到了Apo B目标。
本研究共纳入182例连续的高胆固醇血症患者(男性119例,女性63例),年龄超过18岁(平均年龄:54.96±9.27岁),且正在接受他汀类药物治疗。根据成人治疗小组III报告中定义的心血管风险类别,对达到或未达到LDL-C目标的患者测定Apo B和non-HDL-C水平。采用散射比浊法评估血清Apo B水平。
达到LDL-C、non-HDL-C和Apo B目标的患者患病率分别为63.2%、79.7%和72.5%。所有达到LDL-C目标的患者也达到了non-HDL-C目标。发现115例达到LDL-C和non-HDL-C目标的患者中有6例(5.2%)未达到Apo B目标,而132例达到Apo B目标的患者中有23例(17.4%)未达到LDL-C目标。
这些结果表明,接受他汀类药物治疗且达到LDL-C和non-HDL-C目标的患者中有95%也达到了Apo B目标。