Bagheri Babak, Alikhani Asal, Mokhtari Hossein, Rasouli Mehdi
Departments of Cardiology and Clinical Biochemistry.
Immunogenetics Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Med Arch. 2018 Apr;72(2):103-107. doi: 10.5455/medarh.2018.72.103-107.
The hypothesis is proposed that the atherogenicity of lipoporotein fractions is correlated with the content of unesterified cholesterol.
To evaluate the role and prognostic values of unesterified and esterified cholesterol in lipoprotein fractions for coronary artery disease (CAD).
The study population consisted of 400 patients who were divided to CAD controls and cases according to the data of coronary angiography. Fractional cholesterol esterification (FCE) as well as the complete profile of lipids and (apo)lipoproteins were determined.
Total cholesterol was increased significantly in CAD patients (196.3 ± 52.3 mg/dL vs. 185.7 ± 48.0, p≤ 0.049) and the increment occurred totally in unesterified portion (77.2 ± 28.4 mg/dL vs. 71.1 ± 24.4, p≤ 0.031). HDL cholesterol showed a significant decrease in CAD group (39.9 ± 9.5 mg/dL vs. 44.6 ± 10.5, p≤ 0.001), but the decrement occurred wholly in the esterified portion (26.2 ± 9.2 mg/dL vs. 31.1 ± 8.1, p≤ 0.001). NonHDL cholesterol was increased significantly in CAD group (156.8 ± 48.3 mg/dL vs. 140.3 ± 43.6, p≤ 0.001), and the changes occurred in both un- and esterified portions. FCE in HDL was diminished significantly in CAD patients (64.8 ± 13.9% vs. 69.3 ± 7.9, p≤ 0.01). In multivariate logistic regression analysis, unesterified cholesterol in NonHDL (UeNonHDLc) and esterified cholesterol in HDL (EsHDLc) excluded total cholesterol and HDLc respectively from the regression equation. In ROC analysis, the ratio of UeNonHDLc/EsHDLc was the strongest predictor for CAD among cholesterol subfractions.
The results confirm that UeNonHDLc is atherogenic and EsHDLc is antiatherogenic and are independent risk factors for CAD.
提出了脂蛋白组分的致动脉粥样硬化性与未酯化胆固醇含量相关的假说。
评估未酯化和酯化胆固醇在脂蛋白组分中对冠状动脉疾病（CAD）的作用及预后价值。
研究人群包括400例患者，根据冠状动脉造影数据分为CAD对照组和病例组。测定了胆固醇酯化分数（FCE）以及脂质和（载）脂蛋白的完整谱。
CAD患者的总胆固醇显著升高（196.3±52.3mg/dL对185.7±48.0，p≤0.049），且升高完全发生在未酯化部分（77.2±28.4mg/dL对71.1±24.4，p≤0.031）。CAD组高密度脂蛋白胆固醇显著降低（39.9±9.5mg/dL对44.6±10.5，p≤0.001），但降低完全发生在酯化部分（26.2±9.2mg/dL对31.1±8.1，p≤0.001）。CAD组非高密度脂蛋白胆固醇显著升高（156.8±48.3mg/dL对140.3±43.6，p≤0.001），且未酯化和酯化部分均发生变化。CAD患者高密度脂蛋白中的FCE显著降低（64.8±13.9%对69.3±7.9，p≤0.01）。在多变量逻辑回归分析中，非高密度脂蛋白中的未酯化胆固醇（UeNonHDLc）和高密度脂蛋白中的酯化胆固醇（EsHDLc）分别将总胆固醇和高密度脂蛋白胆固醇从回归方程中排除。在ROC分析中，UeNonHDLc/EsHDLc比值是胆固醇亚组分中CAD的最强预测因子。
结果证实UeNonHDLc具有致动脉粥样硬化性，EsHDLc具有抗动脉粥样硬化性，且是CAD的独立危险因素。
