Karasek David, Vaverkova Helena, Cibickova Lubica, Gajdova Jaromira, Kubickova Veronika
Third Department of Internal Medicine - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, University Hospital and Palacky University, Olomouc, Czech Republic.
Third Department of Internal Medicine - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, University Hospital and Palacky University, Olomouc, Czech Republic.
J Clin Lipidol. 2017 Mar-Apr;11(2):442-449. doi: 10.1016/j.jacl.2017.01.020. Epub 2017 Feb 10.
Both apolipoprotein B (apoB) and non-high-density lipoprotein cholesterol (non-HDL-C) are accepted as alternative risk factors or targets for lipid-lowering therapy, which correlate more strongly with cardiovascular events than low-density lipoprotein cholesterol.
The aim of this cross-sectional study was to evaluate the differences in plasma levels of plasminogen activator inhibitor-1 (PAI-1) and of von Willebrand factor (vWF) as endothelial hemostatic markers and carotid intima-media thickness (C-IMT) as a morphologic marker for atherosclerotic vascular disease among dyslipidemic individuals with apoB levels higher, estimated or lower based on regression equation of apoB vs non-HDL-C.
A total of 594 dyslipidemic subjects without atherosclerotic manifestation were divided into 3 groups (according to tertiles of apoB levels above, within, and below the line of identity): H-apoB (n = 200), E-apoB (n = 194), and L-apoB (n = 200). PAI-1, vWF, C-IMT and lipids, anthropometric parameters, markers of insulin resistance, and inflammation were measured. Differences in variables between groups were analyzed using analysis of variance.
There was a strong association between apoB and non-HDL-C. The correlations of apoB and of non-HDL-C with markers of endothelial damage and C-IMT were very similar. Despite these facts, individuals with higher apoB levels had significantly higher levels of PAI-1 compared with individuals with estimated (P < .05) or lower apoB (P < .001). There were no significant differences in vWF, C-IMT, markers of insulin resistance, obesity, and inflammation.
Individuals with apoB higher than predicted by non-HDL-C had significantly higher levels of PAI-1, which may contribute to the increased risk of future atherothrombotic events.
载脂蛋白B（apoB）和非高密度脂蛋白胆固醇（non-HDL-C）均被视为脂质降低治疗的替代风险因素或目标，它们与心血管事件的相关性比低密度脂蛋白胆固醇更强。
这项横断面研究的目的是评估在根据apoB与non-HDL-C的回归方程估计apoB水平较高、估计水平或较低的血脂异常个体中，作为内皮止血标志物的纤溶酶原激活物抑制剂-1（PAI-1）和血管性血友病因子（vWF）的血浆水平差异，以及作为动脉粥样硬化性血管疾病形态学标志物的颈动脉内膜中层厚度（C-IMT）差异。
总共594名无动脉粥样硬化表现的血脂异常受试者被分为3组（根据apoB水平高于、处于和低于恒等线的三分位数）：高apoB组（n = 200）、估计apoB组（n = 194）和低apoB组（n = 200）。测量了PAI-1、vWF、C-IMT以及血脂、人体测量参数、胰岛素抵抗标志物和炎症指标。使用方差分析分析组间变量的差异。
apoB与non-HDL-C之间存在很强的关联。apoB和non-HDL-C与内皮损伤标志物和C-IMT的相关性非常相似。尽管如此，与估计apoB水平（P <.05）或较低apoB水平（P <.001）的个体相比，apoB水平较高的个体PAI-1水平显著更高。vWF、C-IMT、胰岛素抵抗标志物、肥胖和炎症指标无显著差异。
apoB高于non-HDL-C预测水平的个体PAI-1水平显著更高，这可能导致未来动脉粥样硬化血栓形成事件风险增加。
