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稳定型冠状动脉疾病患者血浆磷脂酶A2浓度与脂蛋白亚组分之间的关系。

Relationship between plasma phospholipase A2 concentrations and lipoprotein subfractions in patients with stable coronary artery disease.

作者信息

Xu Rui-Xia, Zhang Yan, Li Xiao-Lin, Li Sha, Guo Yuan-Lin, Dong Qian, Liu Geng, Li Jian-Jun

机构信息

Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

Clin Chim Acta. 2015 Jun 15;446:195-200. doi: 10.1016/j.cca.2015.04.032. Epub 2015 Apr 28.

Abstract

BACKGROUND

Both increased lipoprotein-associated phospholipase A2 (Lp-PLA2) concentrations and atherogenic lipoprotein subfractions have been shown to reflect unfavourable cardiovascular risk. However, the correlation between Lp-PLA2 and lipoprotein subfractions in patients with coronary artery disease (CAD) has not been assessed yet.

METHODS

A total of 324 consecutive subjects who were not treated with lipid-lowering drugs were enrolled (angiographically proven CAD: n = 253; non-CAD: n = 71). Plasma Lp-PLA2 concentrations were measured using ELISA. The low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions were determined by Lipoprint System.

RESULTS

Plasma Lp-PLA2 concentrations were higher in patients with CAD compared with those without CAD (153.61 ± 78.73 vs. 131.41 ± 65.49 ng/ml, p = 0.028). The univariable correlation analysis revealed that Lp-PLA2 concentrations were positively correlated with the cholesterol concentrations of each LDL subfractions and the intermediate as well as small HDL subfractions, while negatively linked with the LDL particle size and large HDL-cholesterol (HDL-C) concentrations in CAD group. However, no similar results were observed in the non-CAD group. Furthermore, multivariable regression analysis was performed in patients with CAD and showed that plasma Lp-PLA2 concentrations were independently correlated with the cholesterol concentrations of each LDL subfractions [large LDL-cholesterol (LDL-C): β = 0.263, p < 0.001; intermediate LDL-C: β = 0.327, p < 0.001; small LDL-C: β = 0.135, p = 0.033] and small HDL-C (β = 0.133, p = 0.034).

CONCLUSION

Lp-PLA2 concentrations were positively associated with all LDL subfractions and small HDL subfraction, suggesting an interaction between Lp-PLA2 and lipoprotein subfraction phenotypes in the status of CAD.

摘要

背景

脂蛋白相关磷脂酶A2(Lp-PLA2)浓度升高和致动脉粥样硬化脂蛋白亚组分均已被证明可反映不良心血管风险。然而,尚未评估冠状动脉疾病(CAD)患者中Lp-PLA2与脂蛋白亚组分之间的相关性。

方法

共纳入324例未接受降脂药物治疗的连续受试者(血管造影证实的CAD:n = 253;非CAD:n = 71)。采用酶联免疫吸附测定法(ELISA)测量血浆Lp-PLA2浓度。通过脂蛋白分析系统确定低密度脂蛋白(LDL)和高密度脂蛋白(HDL)亚组分。

结果

与无CAD的患者相比,CAD患者的血浆Lp-PLA2浓度更高(153.61±78.73对131.41±65.49 ng/ml,p = 0.028)。单变量相关分析显示,在CAD组中,Lp-PLA2浓度与各LDL亚组分以及中间和小HDL亚组分的胆固醇浓度呈正相关,而与LDL颗粒大小和大HDL胆固醇(HDL-C)浓度呈负相关。然而,在非CAD组中未观察到类似结果。此外,对CAD患者进行多变量回归分析,结果显示血浆Lp-PLA2浓度与各LDL亚组分的胆固醇浓度独立相关[大LDL胆固醇(LDL-C):β = 0.263,p < 0.001;中间LDL-C:β = 0.327,p < 0.001;小LDL-C:β = 0.135,p = 0.033]以及小HDL-C(β = 0.133,p = 0.034)。

结论

Lp-PLA2浓度与所有LDL亚组分和小HDL亚组分呈正相关,提示在CAD状态下Lp-PLA2与脂蛋白亚组分表型之间存在相互作用。

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