Yoshida Hiroshi, Kisugi Reiko, Koike Masaru, Kurosawa Hideo
Department of Laboratory Medicine, Jikei University Kashiwa Hospital, Kashiwa 277-8567, Japan.
Rinsho Byori. 2012 Apr;60(4):343-8.
Lowering low-density lipoprotein (LDL) cholesterol (LDL-C) can reduce the risk of cardiovascular disease (CVD) by approximately 30%, and the remaining 70% should be the second front of CVD risk reduction. Such residual risks include high triglyceride (TG) concentrations and low levels of high-density lipoprotein (HDL) cholesterol (HDL-C) in terms of dyslipidemia. TG-rich lipoproteins are heterogenous and composed of a variety of subfractions, all of which are not necessarily relevant to atherosclerosis and CVD risk. However, remnant lipoproteins, TG-rich lipoproteins, are atherogenic and related to CVD risk. Two different methods (RLP-C and RemL-C) have been developed to measure cholesterol levels of remnant lipoproteins. Although there is a difference in affinity to intermediate-density lipoprotein (IDL) between the two methods, they may be better qualified as biomarkers of CVD risk than TG itself. TG measurements play a certain role in the evaluation of CVD risk, but the remnant lipoprotein cholesterol measurement can provide better screening for patients at high CVD risk than TG and may be a useful examination in both quantity and quality.
降低低密度脂蛋白(LDL)胆固醇(LDL-C)可使心血管疾病(CVD)风险降低约30%,其余70%应成为降低CVD风险的第二个主攻方向。此类残余风险在血脂异常方面包括高甘油三酯(TG)浓度和低水平的高密度脂蛋白(HDL)胆固醇(HDL-C)。富含TG的脂蛋白具有异质性,由多种亚组分组成,并非所有亚组分都与动脉粥样硬化和CVD风险相关。然而,残余脂蛋白,即富含TG的脂蛋白,具有致动脉粥样硬化作用且与CVD风险相关。已开发出两种不同方法(RLP-C和RemL-C)来测量残余脂蛋白的胆固醇水平。尽管这两种方法对中间密度脂蛋白(IDL)的亲和力存在差异,但与TG本身相比,它们可能更有资格作为CVD风险的生物标志物。TG测量在评估CVD风险中发挥一定作用,但测量残余脂蛋白胆固醇比TG能为CVD高风险患者提供更好的筛查,并且在量和质方面可能都是一项有用的检查。