Institute of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, PR China.
Atherosclerosis. 2013 Jun;228(2):438-42. doi: 10.1016/j.atherosclerosis.2013.02.032. Epub 2013 Mar 7.
Phospholipid transfer protein (PLTP) modulates lipoprotein metabolism and plays an important role in inflammation and oxidative stress. High PLTP activity is associated with atherosclerosis and its risk factors, which also predispose to left ventricular systolic (LV) dysfunction and/or congestive heart failure. However there are few data linking PLTP activity directly to LV function. According, we sought to determine the relation between PLTP activity and LV ejection fraction (EF) in a Chinese cohort of 732 patients referred for coronary angiography. Weak but significant correlations of PLTP activity levels were found with age (r = -0.09, p = 0.017), male gender (r = 0.09, p = 0.019), diabetes (r = 0.08, p = 0.036), TG (r = 0.11, p = 0.003), HDL-C (r = -0.18, p = <0.001), apo A (-0.30, p < 0.001) apo B (r = 0.20, p < 0.001), fibrinogen (r = 0.32, p < 0.001) and LVEF (r = -0.12, p = 0.003). Median PLTP activity levels were higher among patients with reduced than in normal LV systolic function (LVEF <50%) [26.7 pmol/microl/h (IQR 20.2, 38.6) vs. 19.9 pmol/microl/h (IQR 12.2, 31.0), p < 0.001]. There was a step-wise increase in median PLTP levels in patients with normal, mild, and moderate-severe degrees of LV dysfunction (19.9 pmol/microl/h vs. 25.1 pmol/microl/h vs. 34.7 pmol/microl/h, p < 0.001). Median PLTP activity levels were higher among patients with unstable rather than stable AP and non-CHD patients (25.9 pmol/microl/h vs 20.2 vs 21.9, p = 0.012). On multivariate analyzes, higher median PLTP activity levels were associated with depressed LV systolic function as a dichotomous variable and with lower LVEF as a continuous variable. In conclusion, higher PLTP activity is associated with depressed LV systolic function in a dose-dependent manner independent of coronary heart disease as well as to unstable CHD.
磷脂转移蛋白 (PLTP) 调节脂蛋白代谢，在炎症和氧化应激中发挥重要作用。高 PLTP 活性与动脉粥样硬化及其危险因素相关，这些因素也易导致左心室收缩 (LV) 功能障碍和/或充血性心力衰竭。然而，将 PLTP 活性直接与 LV 功能相关联的研究数据很少。因此，我们试图在接受冠状动脉造影的 732 名中国患者队列中确定 PLTP 活性与 LV 射血分数 (EF) 之间的关系。PLTP 活性水平与年龄 (r = -0.09, p = 0.017)、男性 (r = 0.09, p = 0.019)、糖尿病 (r = 0.08, p = 0.036)、TG (r = 0.11, p = 0.003)、HDL-C (r = -0.18, p < 0.001)、apo A (-0.30, p < 0.001)、apo B (r = 0.20, p < 0.001)、纤维蛋白原 (r = 0.32, p < 0.001) 和 LVEF (r = -0.12, p = 0.003) 呈弱但显著相关。与左心室收缩功能正常 (LVEF < 50%) 的患者相比，左心室收缩功能降低的患者的 PLTP 活性中位数更高 [26.7 pmol/μl/h (IQR 20.2, 38.6) 与 19.9 pmol/μl/h (IQR 12.2, 31.0), p < 0.001]。在左心室功能轻度、中度和重度障碍的患者中，PLTP 水平呈阶梯式升高 (19.9 pmol/μl/h 与 25.1 pmol/μl/h 与 34.7 pmol/μl/h, p < 0.001)。不稳定型而非稳定性 AP 和非 CHD 患者的 PLTP 活性中位数更高 (25.9 pmol/μl/h 与 20.2 与 21.9, p = 0.012)。在多变量分析中，较高的 PLTP 活性水平与二分类变量的左心室收缩功能降低和连续变量的 LVEF 降低相关。总之，PLTP 活性升高与 LV 收缩功能障碍呈剂量依赖性相关，与冠心病及不稳定型冠心病无关。
