Martínez-Quintana Efrén, Rodríguez-González Fayna
Cardiology Service, Insular-Materno Infantil University Hospital, Las Palmas de Gran Canaria, Spain.
Congenit Heart Dis. 2014 Jan-Feb;9(1):63-8. doi: 10.1111/chd.12093. Epub 2013 May 22.
Lipoprotein(a) (Lp(a)) contributes to the formation to atherosclerosis, promotes inflammation and stimulates prothrombotic processes.
One hundred seventeen adult congenital heart disease (ACHD) patients and 152 controls were studied to compare serum Lp(a) concentrations in different subgroups of congenital heart abnormalities. Analytically, Lp(a), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, triglycerides, and C-reactive protein (CRP) were studied. In congenital heart disease patients, N-terminal-pro-B-type natriuretic peptide levels were also determined.
Thirty-nine (25.6%) patients in the control group and 33 (28.2) ACHD patients (2 hypoxemic and 31 nonhypoxemic) had a Lp(a) concentration higher than 30 mg/dL. No significant differences were seen between patients with Lp(a) concentration ≤30 or >30 mg/dL after performing a binary logistic regression multivariate analysis including as covariates all the variables that showed significance (P < .001) between the case and control groups (age, gender, CRP, and total, LDL, and high-density lipoprotein cholesterol) besides being congenital or not. Similarly, no significant differences were found between ACHD patients with Lp(a) concentration lower and higher than 30 mg/dL after performing a multivariate analysis in which age, sex, body mass index, LDL-cholesterol levels, and being or not hypoxemic were included as covariates. Pearson's correlation showed a significant positive correlation (0.27) between LDL-cholesterol and Lp(a) concentrations (P = .004) and between CRP and N-terminal-pro-B-type natriuretic peptide levels (0.19) in ACHD patients (P = .035).
Adult congenital heart disease patients showed lower serum total cholesterol and LDL-cholesterol levels than no-congenital patients although no significant differences were seen in Lp(a) concentrations between both groups.
脂蛋白(a)（Lp(a)）有助于动脉粥样硬化的形成，促进炎症反应并刺激血栓形成过程。
对117例成人先天性心脏病（ACHD）患者和152例对照者进行研究，以比较不同先天性心脏异常亚组中的血清Lp(a)浓度。分析测定了Lp(a)、总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白胆固醇、甘油三酯和C反应蛋白（CRP）。在先天性心脏病患者中，还测定了N末端B型利钠肽前体水平。
对照组中有39例（25.6%）患者以及33例（28.2%）ACHD患者（2例低氧血症患者和31例非低氧血症患者）的Lp(a)浓度高于30mg/dL。在进行二元逻辑回归多变量分析后，Lp(a)浓度≤30或>30mg/dL的患者之间未发现显著差异，该分析将所有在病例组和对照组之间显示出显著性（P<.001）的变量（年龄、性别、CRP以及总胆固醇、LDL和高密度脂蛋白胆固醇）作为协变量，此外还考虑了是否为先天性疾病。同样，在将年龄、性别、体重指数、LDL胆固醇水平以及是否为低氧血症作为协变量进行多变量分析后，Lp(a)浓度低于和高于30mg/dL 的ACHD患者之间也未发现显著差异。Pearson相关性分析显示，ACHD患者中LDL胆固醇与Lp(a)浓度之间存在显著正相关（0.27）（P=.004），CRP与N末端B型利钠肽前体水平之间也存在显著正相关（0.19）（P=.035）。
成人先天性心脏病患者的血清总胆固醇和LDL胆固醇水平低于非先天性心脏病患者，尽管两组之间的Lp(a)浓度未发现显著差异。
