Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Vascular Medicine Program, Sulpizio Cardiovascular Center, Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA; Division of Cardiology, Chonbuk National University Hospital and Chonbuk School of Medicine, Jeonju, Korea.
J Clin Lipidol. 2018 Nov-Dec;12(6):1493-1501.e11. doi: 10.1016/j.jacl.2018.08.010. Epub 2018 Aug 29.
BACKGROUND: Plasma apolipoprotein C-III (apoC-III) levels are associated with coronary artery disease (CAD) risk. OBJECTIVE: To assess whether lipoprotein-associated apoC-III levels predict risk of CAD events. METHODS: apoC-III associated with apoB, apoAI, and Lp(a) (apoCIII-apoB, apoCIII-apoAI, and apoCIII-Lp(a), respectively) were measured using high-throughput chemiluminescent enzyme-linked immunoassays in 2711 subjects (1879 controls and 832 cases with CAD) in the European Prospective Investigation into Cancer and Nutrition-Norfolk prospective population study with 7.4 years of follow-up. These measures were correlated with a variety of lipid measurements and the presence of CAD. The indices of "total apoCIII-apoB" and "total apoCIII-apoAI" were derived by multiplying plasma apoB and apoAI, respectively. RESULTS: apoCIII-apoB (P = .001), apoCIII-Lp(a) (P < .001), apoCIII-apoAI (P = .005) were higher in cases vs controls; tended to correlate positively with body mass index, hsCRP, apoC-III, low-density lipoprotein (LDL) cholesterol, triglycerides, remnant cholesterol, very low density lipoprotein, LDL and high-density lipoprotein particle number and very low density lipoprotein size; but negatively with LDL and high-density lipoprotein particle size (P < .001 for all). apoCIII-apoB, apoCIII-apoAI, apoCIII-Lp(a), total apoCIII-Lp(a), and total apoCIII-apoB were predictors of CAD after adjustment of age, sex, body mass index, smoking, diabetes, hypertensive and lipid-lowering drug use, but they lost their significance after further adjustment of lipid and lipoprotein variables. CONCLUSIONS: This study suggests that enzyme-linked immunoassay-measured lipoprotein-associated apoC-III markers reflect atherogenic lipid particles but do not independently predict risk of CAD events.
背景:血浆载脂蛋白 C-III(apoC-III)水平与冠状动脉疾病(CAD)风险相关。
目的:评估脂蛋白相关 apoC-III 水平是否可预测 CAD 事件风险。
方法:在欧洲前瞻性癌症与营养研究-诺福克前瞻性人群研究中,对 2711 例受试者(1879 例对照和 832 例 CAD 病例)进行了 7.4 年的随访,采用高通量化学发光酶联免疫吸附法测定了载脂蛋白 B(apoB)、载脂蛋白 AI(apoAI)和脂蛋白 a(Lp(a))相关的 apoC-III(分别为 apoCIII-apoB、apoCIII-apoAI 和 apoCIII-Lp(a))。这些指标与各种脂质测量值和 CAD 的存在相关。通过分别乘以血浆 apoB 和 apoAI,得出“总 apoCIII-apoB”和“总 apoCIII-apoAI”指数。
结果:病例组 apoCIII-apoB(P=0.001)、apoCIII-Lp(a)(P<0.001)、apoCIII-apoAI(P=0.005)均高于对照组;与体重指数、高敏 C 反应蛋白(hsCRP)、apoC-III、低密度脂蛋白胆固醇(LDL-C)、甘油三酯、残余胆固醇、极低密度脂蛋白(VLDL)、LDL 和高密度脂蛋白(HDL)颗粒数以及 VLDL 大小呈正相关(所有 P<0.001);与 LDL 和 HDL 颗粒大小呈负相关(P<0.001)。在调整年龄、性别、体重指数、吸烟、糖尿病、高血压和降脂药物使用后,apoCIII-apoB、apoCIII-apoAI、apoCIII-Lp(a)、总 apoCIII-Lp(a)和总 apoCIII-apoB 是 CAD 的预测因素,但在进一步调整脂质和脂蛋白变量后,这些因素失去了意义。
结论:本研究表明,酶联免疫吸附法测定的脂蛋白相关 apoC-III 标志物反映了致动脉粥样硬化的脂质颗粒,但不能独立预测 CAD 事件的风险。
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