Department of Intensive Cardiac Therapy, Central Teaching Hospital of the Medical University of Lodz, Lodz, Poland.
Department of Nephrology, Hypertension and Family Medicine, WAM Teaching Hospital, Zeromskiego 113; 90-549 Lodz, Poland.
Curr Vasc Pharmacol. 2019;17(4):365-375. doi: 10.2174/1570161116666180601083225.
There is a close relationship between lipid metabolism disorders and atherosclerosis. Guidelines focus on lowering Low-Density Lipoprotein Cholesterol (LDL-C) levels. However, it should be kept in mind that LDL and High-Density Lipoprotein (HDL) consist of subfractions which can affect the progression of atherosclerosis.
We assessed the concentration of LDL and HDL subfractions in patients with Acute Coronary Syndromes (ACS). The influence of the presence of type 2 diabetes mellitus on LDL and HDL subfractions was also analyzed.
The study group consisted of 127 patients (62 men, 65 women) with ACS. All patients had coronary angiography and coronary angioplasty and stenting when necessary. Medical history was collected during 12 months of follow-up. HDL and LDL subfraction distribution was measured using Lipoprint (Quantimetrix).
No differences in LDL nor HDL subfractions were observed between ST-Segment Elevation Myocardial Infarction (STEMI), Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) and unstable angina (UA) patients. However, those with restenosis and the necessity of repeated revascularization had higher levels of intermediate-density lipoprotein C (IDL-C) (p=0.055) and LDL3 (p=0.048) as compared with the patients without, while the level of IDL A (IDLA) was lower than in the latter group (p=0.036). In diabetic patients, the percentage share of HDL10 and small-dense HDL was significantly higher while the share of HDL1 (small-dense) (p=0.028), HDL4 (intermediate density) (p=0.052) and HDL5 (intermediate density) (p=0.060) were lower than in patients without DM.
Patients with multi-vessel CAD disease had higher levels of LDL3 subfraction and IDL-C and a lower proportion of IDLA.
脂质代谢紊乱与动脉粥样硬化密切相关。指南侧重于降低低密度脂蛋白胆固醇（LDL-C）水平。然而，应该记住，LDL 和高密度脂蛋白（HDL）由亚组分组成，这会影响动脉粥样硬化的进展。
我们评估了急性冠状动脉综合征（ACS）患者的 LDL 和 HDL 亚组分浓度。还分析了 2 型糖尿病对 LDL 和 HDL 亚组分的影响。
研究组包括 127 名 ACS 患者（62 名男性，65 名女性）。所有患者均接受冠状动脉造影和必要时进行冠状动脉血管成形术和支架置入术。在 12 个月的随访期间收集了病史。使用 Lipoprint（Quantimetrix）测量 HDL 和 LDL 亚组分分布。
STEMI、NSTEMI 和不稳定型心绞痛（UA）患者之间的 LDL 和 HDL 亚组分无差异。然而，与无再狭窄和无需再次血运重建的患者相比，有再狭窄和需要重复血运重建的患者中间密度脂蛋白 C（IDL-C）（p=0.055）和 LDL3（p=0.048）水平更高，而 IDL A（IDLA）水平较低（p=0.036）。在糖尿病患者中，HDL10 和小而密 HDL 的百分比明显更高，而 HDL1（小而密）（p=0.028）、HDL4（中间密度）（p=0.052）和 HDL5（中间密度）（p=0.060）的比例低于无 DM 患者。
多支血管 CAD 疾病患者的 LDL3 亚组分和 IDL-C 水平较高，IDLA 比例较低。
