Cumming School of Medicine, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Division of Cardiac Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Can J Cardiol. 2017 Oct;33(10):1305-1311. doi: 10.1016/j.cjca.2017.08.004. Epub 2017 Aug 16.
Apolipoprotein B (apoB) and apolipoprotein A-1 (apoA-1) are markers of lipoprotein metabolism. Although their relationship to cardiovascular disease has been well documented, little is known regarding their correlation to measures of vascular structure and function. This study was conducted to investigate the relationship between apoA-1, apoB, and measures of vascular function, as well their relationship to adverse cardiovascular events. Moreover, we evaluated whether apoB or the apoB/apoA-1 ratio was more closely related to vascular markers than was low-density lipoprotein cholesterol (LDL-C) or non-high-density lipoprotein cholesterol (non-HDL-C).
One thousand five hundred twenty-two healthy middle-aged men of the Firefighters and Their Endothelium (FATE) cohort were assessed for risk factors and flow-mediated dilatation (FMD), hyperemic velocity (VTI), and carotid intima-media thickness (CIMT). Participants were then followed for 7.2 ± 1.7 years. ApoA-1 and apoB levels were measured at baseline.
ApoA-1 was not correlated with VTI, FMD, or CIMT, whereas apoB was significantly related to VTI and CIMT. Multiple regression analyses confirmed apoB as being related to both VTI (β = -0.083; P = 0.001) and CIMT (β = 0.055; P = 0.022) in models adjusted for age; blood pressure; high-density lipoprotein C (HDL-C), triglyceride and insulin levels; waist circumference; and C-reactive protein levels. In substituted models, LDL-C (β = -0.092; P < 0.001) and non-HDL-C (β = -0.089; P = 0.001) levels appeared to have the same degree of association as apoB for VTI but were not associated with CIMT. ApoB was found to be associated with cardiovascular events (hazard ratio, 1.349; 95% confidence interval, 1.073-1.695; P = 0.010).
ApoB had an independent but weak relationship with indices of microvascular health. Nevertheless, it was associated with occurrence rates of adverse cardiovascular events.
载脂蛋白 B（apoB）和载脂蛋白 A-1（apoA-1）是脂蛋白代谢的标志物。尽管它们与心血管疾病的关系已得到充分证实，但对于它们与血管结构和功能测量值的相关性知之甚少。本研究旨在调查 apoA-1、apoB 与血管功能测量值之间的关系，以及它们与不良心血管事件的关系。此外，我们评估了 apoB 或 apoB/apoA-1 比值与血管标志物的相关性是否比低密度脂蛋白胆固醇（LDL-C）或非高密度脂蛋白胆固醇（non-HDL-C）更密切。
对 1522 名健康中年消防员及其内皮细胞（FATE）队列的参与者进行了危险因素评估以及血流介导的扩张（FMD）、充血速度（VTI）和颈动脉内膜中层厚度（CIMT）检查。然后，参与者随访了 7.2±1.7 年。在基线时测量了 apoA-1 和 apoB 水平。
apoA-1 与 VTI、FMD 或 CIMT 均不相关，而 apoB 与 VTI 和 CIMT 显著相关。多元回归分析证实，apoB 与调整年龄、血压、高密度脂蛋白 C（HDL-C）、甘油三酯和胰岛素水平、腰围和 C 反应蛋白水平后的 VTI（β=-0.083；P=0.001）和 CIMT（β=0.055；P=0.022）均相关。在替代模型中，LDL-C（β=-0.092；P<0.001）和非-HDL-C（β=-0.089；P=0.001）水平似乎与 VTI 的关联程度与 apoB 相同，但与 CIMT 无关。apoB 与心血管事件（危险比，1.349；95%置信区间，1.073-1.695；P=0.010）相关。
apoB 与微血管健康指数有独立但较弱的关系。然而，它与不良心血管事件的发生率有关。
