Armstrong V W, Cremer P, Eberle E, Manke A, Schulze F, Wieland H, Kreuzer H, Seidel D
Atherosclerosis. 1986 Dec;62(3):249-57. doi: 10.1016/0021-9150(86)90099-7.
Lipoprotein(a) concentrations were measured by radial immunodiffusion in a cohort of 40-60 year males who had been classified by coronary angiography as CAD+ with 50% stenosis of one or more of the major coronary arteries or CAD- with no signs of coronary lesions. Sample odds ratios were calculated as a measure of association between serum Lp(a) values and the presence of coronary artery disease. An odds ratio of 2.706 (P less than 0.001) was derived for elevated (greater than or equal to 30 mg/dl) Lp(a) levels vs low (less than 5 mg/dl) Lp(a) levels indicating a strong association between the presence of coronary artery disease and elevated Lp(a) concentrations. This association was independent of the known risk factors smoking, hypertension and diabetes as well as the serum concentrations of total triglycerides, HDL-cholesterol, alpha-Lp-cholesterol and pre-beta-Lp-cholesterol. In contrast to these variables the association between Lp(a) and coronary artery disease was dependent upon the serum concentrations of LDL-cholesterol, beta-Lp-cholesterol and total cholesterol. At concentrations below the respective median for each variable, odds ratios of between 1.42 and 1.67 were calculated whereas at concentrations above the respective medians the odds ratios ranged from 4.50 to 6.33 (P less than 0.001). Our data, therefore, suggest that increasing LDL concentrations markedly increase the risk of coronary artery disease due to elevated Lp(a) levels.
采用放射免疫扩散法测定了一组40至60岁男性的脂蛋白(a)浓度。这些男性通过冠状动脉造影被分类为CAD+（一条或多条主要冠状动脉狭窄50%）或CAD-（无冠状动脉病变迹象）。计算样本比值比作为血清Lp(a)值与冠状动脉疾病存在之间关联的一种度量。对于Lp(a)水平升高（大于或等于30mg/dl）与低水平（小于5mg/dl）相比，得出的比值比为2.706（P小于0.001），表明冠状动脉疾病的存在与Lp(a)浓度升高之间存在强烈关联。这种关联独立于已知的危险因素吸烟、高血压和糖尿病，以及总甘油三酯、高密度脂蛋白胆固醇、α-Lp胆固醇和前β-Lp胆固醇的血清浓度。与这些变量相反，Lp(a)与冠状动脉疾病之间的关联取决于低密度脂蛋白胆固醇、β-Lp胆固醇和总胆固醇的血清浓度。在每个变量各自中位数以下的浓度时，计算出的比值比在1.42至1.67之间，而在各自中位数以上的浓度时，比值比范围为4.50至6.33（P小于0.001）。因此，我们的数据表明，由于Lp(a)水平升高，低密度脂蛋白浓度的增加显著增加了冠状动脉疾病的风险。
