血清低密度脂蛋白胆固醇水平得到控制的腹膜透析患者中极低密度脂蛋白与踝臂指数的关联。

The association of very-low-density lipoprotein with ankle-brachial index in peritoneal dialysis patients with controlled serum low-density lipoprotein cholesterol level.

作者信息

Kanda Eiichiro, Ai Masumi, Okazaki Mitsuyo, Maeda Yoshitaka, Sasaki Sei, Yoshida Masayuki

机构信息

Department of Nephrology, Tokyo Kyosai Hospital, Nakameguro 2-3-8, Meguroku, Tokyo 153-8934, Japan.

出版信息

BMC Nephrol. 2013 Oct 7;14:212. doi: 10.1186/1471-2369-14-212.

DOI:10.1186/1471-2369-14-212

PMID:24093487

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3853217/

Abstract

BACKGROUND

Peripheral artery disease (PAD) represents atherosclerotic disease and is a risk factor for death in peritoneal dialysis (PD) patients, who tend to show an atherogenic lipid profile. In this study, we investigated the relationship between lipid profile and ankle-brachial index (ABI) as an index of atherosclerosis in PD patients with controlled serum low-density lipoprotein (LDL) cholesterol level.

METHODS

Thirty-five PD patients, whose serum LDL cholesterol level was controlled at less than 120 mg/dl, were enrolled in this cross-sectional study in Japan. The proportions of cholesterol level to total cholesterol level (cholesterol proportion) in 20 lipoprotein fractions and the mean size of lipoprotein particles were measured using an improved method, namely, high-performance gel permeation chromatography. Multivariate linear regression analysis was adjusted for diabetes mellitus and cardiovascular and/or cerebrovascular diseases.

RESULTS

The mean (standard deviation) age was 61.6 (10.5) years; PD vintage, 38.5 (28.1) months; ABI, 1.07 (0.22). A low ABI (0.9 or lower) was observed in 7 patients (low-ABI group). The low-ABI group showed significantly higher cholesterol proportions in the chylomicron fraction and large very-low-density lipoproteins (VLDLs) (Fractions 3-5) than the high-ABI group (ABI>0.9). Adjusted multivariate linear regression analysis showed that ABI was negatively associated with serum VLDL cholesterol level (parameter estimate=-0.00566, p=0.0074); the cholesterol proportions in large VLDLs (Fraction 4, parameter estimate=-3.82, p=0.038; Fraction 5, parameter estimate=-3.62, p=0.0039) and medium VLDL (Fraction 6, parameter estimate=-3.25, p=0.014); and the size of VLDL particles (parameter estimate=-0.0352, p=0.032).

CONCLUSIONS

This study showed that the characteristics of VLDL particles were associated with ABI among PD patients. Lowering serum VLDL level may be an effective therapy against atherosclerosis in PD patients after the control of serum LDL cholesterol level.

摘要

背景

外周动脉疾病（PAD）是一种动脉粥样硬化性疾病，是腹膜透析（PD）患者死亡的危险因素，这类患者往往具有致动脉粥样硬化的血脂谱。在本研究中，我们调查了在血清低密度脂蛋白（LDL）胆固醇水平得到控制的PD患者中，血脂谱与作为动脉粥样硬化指标的踝臂指数（ABI）之间的关系。

方法

35例血清LDL胆固醇水平控制在120mg/dl以下的PD患者参与了日本的这项横断面研究。使用一种改进的方法，即高效凝胶渗透色谱法，测量了20种脂蛋白组分中胆固醇水平占总胆固醇水平的比例（胆固醇比例）以及脂蛋白颗粒的平均大小。多变量线性回归分析对糖尿病以及心血管和/或脑血管疾病进行了校正。

结果

平均（标准差）年龄为61.6（10.5）岁；PD病程为38.5（28.1）个月；ABI为1.07（0.22）。7例患者（低ABI组）观察到低ABI（0.9或更低）。低ABI组乳糜微粒组分和大的极低密度脂蛋白（VLDL）（组分3 - 5）中的胆固醇比例显著高于高ABI组（ABI>0.9）。校正后的多变量线性回归分析显示，ABI与血清VLDL胆固醇水平呈负相关（参数估计值=-0.00566，p = 0.0074）；大的VLDL（组分4，参数估计值=-3.82，p = 0.038；组分5，参数估计值=-3.62，p = 0.0039）和中等VLDL（组分6，参数估计值=-3.25，p = 0.014）中的胆固醇比例；以及VLDL颗粒大小（参数估计值=-0.0352，p = 0.032）。